Efficacy and ovarian preservation of combined uterine and ovarian artery embolization in adenomyosis with significant collateral supply

Jianfeng He, Tenghui Zhan
Medicine · 2025 · vol. 104(44) , pp. e45656 · doi:10.1097/md.0000000000045656 · PMID:41261647 · PMC12582830 · W4416365092
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Abstract

Uterine artery embolization (UAE) is an effective treatment for adenomyosis, but ovarian collateral supply can increase the risk of recurrence. This study aimed to explore the safety and efficacy of combined UAE and unilateral ovarian artery embolization (OAE) in adenomyosis patients with ovarian artery collateral supply exceeding 10% of ipsilateral uterine perfusion, particularly focusing on ovarian function. This single-center retrospective study was conducted at Fujian Maternity and Child Health Hospital from June 2021 to April 2023, including 23 eligible patients, with 18 completing the 12-month follow-up. The exposure was combined UAE + OAE treatment, with outcome variables including reproductive hormone levels, ovarian reserve function, and clinical symptom improvement. At 12 months, the median symptom severity score decreased by 79% (57→12, Δ45 [95%CI 38-52], P <.001), quality of life score increased by 95% (40→78, Δ38 [32-44], P <.001), and pain score (numerical rating scale) decreased by 71% (7→2, Δ5 [4-6], P <.001). anti-Müllerian hormone transiently declined at 3 months (3.91→1.86 ng/mL, Δ-2.05 [-2.41 to -1.69], P = .006) but recovered by 6 months (4.01 ng/mL) and remained stable at 12 months (4.18 ng/mL). Follicle-stimulating hormone, luteinizing hormone, and antral follicle count (AFC) remained stable (P >.4), all patients resumed regular menses without menopausal symptoms, and no major complications were reported. In this small, single-center cohort of relatively young adenomyosis patients with significant ovarian artery collateral supply, combined UAE + OAE was associated with symptom improvement and no measurable impairment of ovarian reserve over 12 months. However, confirmation of the safety and efficacy of combined UAE + OAE in younger adenomyosis patients requires data from larger, multicenter cohorts and randomized trials.

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Outcome instruments

NRS-pain

Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Embolization, Therapeutic Embolization, Therapeutic Embolization, Therapeutic Embolization, Therapeutic Embolization, Therapeutic Embolization, Therapeutic Embolization, Therapeutic Ovary Ovary Ovary Ovary Ovary Ovary

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