{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:13:58Z","timestamp":1788455638367,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine treatment options (myomectomy vs. uterine artery embolization (UAE)) for women wishing to avoid hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter randomized controlled trial was conducted on 254 women and data were collected on fibroid\u2010specific quality of life (UFS\u2010QOL), loss of menstrual blood, and pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At 4\u2009years, the mean difference in the UFS\u2010QOL was 5.0 points (95% confidence interval (CI) \u22121.4 to 11.5; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.13) in favor of myomectomy. This was not statistically significant as it was at 2\u2009years. There were no differences in bleeding scores, rates of amenorrhea, or heavy bleeding. Of those who were still menstruating, the majority reported regular or fairly regular periods: 36 of 48 (75%) in the UAE group and 30 of 39 (77%) in the myomectomy group. Twelve women after UAE and six women after myomectomy became pregnant (4\u2009years) with seven and five live births, respectively (hazard ratio 0.48, 95% CI 0.18\u20131.28). There was no difference between the levels of hormones associated with the uterine reserve in each group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Leiomyoma are common in reproductive\u2010aged women, causing heavy menses and subfertility. Among women with uterine fibroids, myomectomy resulted in better fibroid\u2010related quality of life at 4\u2009years, compared with UAE but the treatments decreased menstrual bleeding equally. There was also no significant difference in the impact of treatment on ovarian reserve.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.14626","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T14:57:01Z","timestamp":1670943421000},"page":"492-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Effects on heavy menstrual bleeding and pregnancy of uterine artery embolization (<scp>UAE<\/scp>) or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: The <scp>FEMME<\/scp> randomized controlled trial"],"prefix":"10.1002","volume":"160","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-5763","authenticated-orcid":false,"given":"Fusun","family":"Sirkeci","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology St Mary's Hospital, Manchester NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Moss","sequence":"additional","affiliation":[{"name":"School of Medicine University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Belli","sequence":"additional","affiliation":[{"name":"Department of Radiology St George's Hospital and Medical School  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klim","family":"McPherson","sequence":"additional","affiliation":[{"name":"Department of Primary Care University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Daniels","sequence":"additional","affiliation":[{"name":"Nottingham Clinical Trials Unit University of Nottingham  Nottingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Manyonda","sequence":"additional","affiliation":[{"name":"Department of Gynaecology St George's Hospital and Medical School  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Middleton","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Versha","family":"Cheed","sequence":"additional","affiliation":[{"name":"Birmingham Clinical Trials Unit University of Birmingham  Birmingham UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute of Health and Wellbeing University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary A.","family":"Lumsden","sequence":"additional","affiliation":[{"name":"School of Medicine University of Glasgow  Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the FEMME Trial Collaborative Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.14640"},{"key":"e_1_2_11_3_1","unstructured":"Office for National Statistics.Childbearing for Women Born in Different Years England and Wales.2020. 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