{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T23:01:29Z","timestamp":1791414089144,"version":"4.3.3"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Uterine leiomyoma is a common condition affecting women that occurs in more than 70% of females. Women with leiomyomas overall have lower quality of life and deficiency in many specific spheres of life including work-related productivity, sexuality, relationships, social\u2013emotional health, and physical well-being that might be present even in pre-and extended throughout early postmenopausal life. Choices for symptomatic fibroid management include medical, interventional radiology procedures, surgical, and expectant management. The uterine artery embolization (UAE) procedure has gained justified popularity for myoma management. Growth factors, vascular endothelial growth factor (VEGF) and tumor growth factor \u03b2 (TGF-\u03b2), hold an important role in leiomyoma progression. However, blood levels of VEGF and TGF-\u03b2 in patients before and after UAE are not fully investigated and the possible relationship with myoma shrinkage has not been evaluated. Therefore, this study aims to assess menorrhagia score and quality of life improvement after UAE for uterine fibroids and compare blood levels of VEGF and TGF-\u03b2 in patients with uterine leiomyoma before and after UAE. This cross-sectional study will be performed at the University Medical Center, Astana, Kazakhstan. Women undergoing the UAE procedure for uterine leiomyoma will be involved in the study following the precisely defined inclusion\/exclusion criteria. Uterine leiomyoma nodules\u2019 structural changes after UAE will be assessed along with the blood levels of growth factors (VEGF and TGF-\u03b2), menorrhagia score, and quality of life. An important outcome of this project will be an investigation of the blood levels of growth factors (VEGF and TGF-\u03b2) before and after the procedure and their association with leiomyoma shrinkage in correlation with the menorrhagia score and quality of life alterations among patients undergoing UAE.<\/jats:p>","DOI":"10.3389\/fmed.2024.1382822","type":"journal-article","created":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T11:13:23Z","timestamp":1722942803000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["The role of VEGF and TGF-\u03b2 blood levels for fibroid shrinkage, menorrhagia score, and quality of life improvement after uterine artery embolization for uterine fibroids: a study protocol"],"prefix":"10.3389","volume":"11","author":[{"given":"Gulzhanat","family":"Aimagambetova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauri","family":"Bapayeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talshyn","family":"Ukybassova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viktor","family":"Zemlyanskiy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnur","family":"Gusmanov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Terzic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1186\/s12889-023-15765-x","article-title":"Global, regional, and national time trends in incidence, prevalence, years lived with disability for uterine fibroids, 1990-2019: an age-period-cohort analysis for the global burden of disease 2019 study","volume":"23","author":"Lou","year":"2023","journal-title":"BMC Public Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e49943","DOI":"10.7759\/cureus.49943","article-title":"Unnecessary hysterectomies among premenopausal women in developed and developing countries: a critical review of steps taken to improve Women's health","volume":"15","author":"Aggarwal","year":"2023","journal-title":"Cureus"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1016\/j.jmig.2023.07.001","article-title":"The effect of a myomectomy on Myoma-related symptoms and quality of life: a retrospective cohort study","volume":"30","author":"Don","year":"2023","journal-title":"J Minim Invasive Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"275.e1","DOI":"10.1016\/j.ajog.2023.05.020","article-title":"Long-term health-related quality of life and symptom severity following hysterectomy, myomectomy, or uterine artery embolization for the treatment of symptomatic uterine fibroids","volume":"229","author":"Anchan","year":"2023","journal-title":"Am J Obstet Gynecol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/s12905-022-01627-y","article-title":"Comparison of two invasive non-surgical treatment options for uterine myomas: uterine artery embolization and magnetic resonance guided high intensity focused ultrasound\u2014 systematic review","volume":"22","author":"Yerezhepbayeva","year":"2022","journal-title":"BMC Womens Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1016\/j.tjog.2018.10.021","article-title":"Repeated pulmonary embolism with cardiac arrest after uterine artery embolization for uterine arteriovenous malformation: a case report and literature review","volume":"57","author":"Imankulova","year":"2018","journal-title":"Taiwan J Obstet Gynecol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"165","DOI":"10.4103\/GMIT.GMIT_50_19","article-title":"Evaluation of uterine artery embolization on Myoma shrinkage: results from a large cohort analysis","volume":"8","author":"Ukybassova","year":"2019","journal-title":"Gynecol Minim Invasive Ther"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1016\/j.ejogrb.2020.11.027","article-title":"Uterine artery embolization versus surgical treatment in patients with symptomatic uterine fibroids: protocol for a systematic review and meta-analysis of individual participant data","volume":"256","author":"Middelkoop","year":"2021","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1016\/S0140-6736(95)92282-2","article-title":"Arterial embolisation to treat uterine myomata","volume":"346","author":"Ravina","year":"1995","journal-title":"Lancet"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s13244-022-01244-1","article-title":"Short-and long-term evaluation of disease-specific symptoms and quality of life following uterine artery embolization of fibroids","volume":"13","author":"Psilopatis","year":"2022","journal-title":"Insights Imaging"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e100","DOI":"10.1097\/AOG.0000000000004401","article-title":"Management of Symptomatic Uterine Leiomyomas: ACOG practice bulletin, number 228","volume":"137","year":"2021","journal-title":"Obstet Gynecol"},{"key":"ref12","year":"2013"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1007\/s00270-022-03349-y","article-title":"CIRSE standards of practice on arterial access for interventions","volume":"46","author":"Memarian","year":"2023","journal-title":"Cardiovasc Intervent Radiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1093\/humupd\/dmr031","article-title":"Growth factors and myometrium: biological effects in uterine fibroid and possible clinical implications","volume":"17","author":"Ciarmela","year":"2011","journal-title":"Hum Reprod Update"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.bpobgyn.2015.08.018","article-title":"Growth factors and pathogenesis","volume":"34","author":"Islam","year":"2016","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1289\/ehp.00108s5795","article-title":"Immunohistochemical localization of growth factors and their receptors in uterine leiomyomas and matched myometrium","volume":"108","author":"Dixon","year":"2000","journal-title":"Environ Health Perspect"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2435","DOI":"10.3390\/ijms18112435","article-title":"Role of transforming growth factor \u03b2 in uterine fibroid biology","volume":"18","author":"Ciebiera","year":"2017","journal-title":"Int J Mol Sci"},{"key":"ref18","article-title":"Physiology, growth factor","volume-title":"Stat pearls","author":"Stone","year":"2024"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1779","DOI":"10.7150\/ijms.75203","article-title":"The potential of transforming growth factor-beta inhibitor and vascular endothelial growth factor inhibitor as therapeutic agents for uterine leiomyoma","volume":"19","author":"Park","year":"2022","journal-title":"Int J Med Sci"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1093\/humupd\/dmt042","article-title":"The role of angiogenic factors in fibroid pathogenesis: potential implications for future therapy","volume":"20","author":"Tal","year":"2014","journal-title":"Hum Reprod Update"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"343","DOI":"10.2174\/187152508785909528","article-title":"Inhibitors of vascular endothelial growth factor in cancer","volume":"6","author":"Pourgholami","year":"2008","journal-title":"Cardiovasc Hematol Agents Med Chem"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"166","DOI":"10.17772\/gp\/60979","article-title":"Expression of VEGF isoforms and their receptors in uterine myomas","volume":"87","author":"Plewka","year":"2016","journal-title":"Ginekol Pol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"645","DOI":"10.3892\/etm.2015.2924","article-title":"IGF-1 and VEGF can be used as prognostic indicators for patients with uterine fibroids treated with uterine artery embolization","volume":"11","author":"Mu","year":"2016","journal-title":"Exp Ther Med"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"5778","DOI":"10.3390\/ijms24065778","article-title":"Update on the role and regulatory mechanism of extracellular matrix in the pathogenesis of uterine fibroids","volume":"24","author":"Yang","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"102037","DOI":"10.1016\/j.jogoh.2020.102037","article-title":"Serum transforming growth factor \u03b2 and leucine-rich \u03b1-2-glycoprotein 1 as potential biomarkers for diagnosis of uterine leiomyomas","volume":"50","author":"Kamalipooya","year":"2021","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"290","DOI":"10.1016\/s0029-7844(01)01702-1","article-title":"The UFS-QOL, a new disease-specific symptom and health-related quality of life questionnaire for leiomyomata","volume":"99","author":"Spies","year":"2002","journal-title":"Obstet Gynecol"},{"key":"ref27","first-page":"290\u2013300","article-title":"The UFS-QOL, a new diseasespecific symptom and health-related quality of life questionnaire for leiomyomata","volume":"99","author":"Spies","year":"2002","journal-title":"Qual Life Res"},{"key":"ref28","year":""},{"key":"ref29","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1111\/j.1471-0528.1990.tb16249.x","article-title":"Assessment of menstrual blood loss using a pictorial chart","volume":"97","author":"Higham","year":"1990","journal-title":"Br J Obstet Gynaecol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12905-020-0887-y","article-title":"Pictorial methods to assess heavy menstrual bleeding in research and clinical practice: a systematic literature review","volume":"20","author":"Magnay","year":"2020","journal-title":"BMC Womens Health"},{"key":"ref31","volume-title":"Stata statistical software: Release 16","year":"2019"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1093\/humupd\/dmw023","article-title":"Uterine fibroid management: from the present to the future","volume":"22","author":"Donnez","year":"2016","journal-title":"Hum Reprod Update"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"201","DOI":"10.2478\/s11536-010-0077-7","article-title":"Hydatiform mole mimicking enlarged uterine Fibromyoma four months after ART","volume":"6","author":"Terzic","year":"2011","journal-title":"Cent Eur J Med"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"136","DOI":"10.12892\/ejgo4630.2019","article-title":"Anaplastic T-cell lymphoma of the urinary bladder with unspecific clinical and radiological characteristics \u2013 a unique case report","volume":"40","author":"Terzic","year":"2019","journal-title":"Eur J Gynecol Oncol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"4480","DOI":"10.3390\/ijerph20054480","article-title":"Reproductive and obstetric outcomes after UAE, HIFU, and TFA of uterine fibroids: systematic review and Meta-analysis","volume":"20","author":"Akhatova","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1055\/s-0032-1328724","article-title":"Vaginal removal of very large nascent uterine Myoma\u2013case report and literature review","volume":"73","author":"Terzic","year":"2013","journal-title":"Geburtsh Frauenheilk"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1151901","DOI":"10.3389\/fsurg.2023.1151901","article-title":"Myomectomy in infertile women: more harm than good?","volume":"10","author":"Mercorio","year":"2023","journal-title":"Front Surg"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e40372","DOI":"10.7759\/cureus.40372","article-title":"Comparison of recurrence and quality of life between Myoma embolization and myomectomy","volume":"15","author":"Akt\u00fcrk","year":"2023","journal-title":"Cureus"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"6110","DOI":"10.3310\/ZDEG6110","article-title":"Uterine artery embolisation versus myomectomy for premenopausal women with uterine fibroids wishing to avoid hysterectomy: the FEMME RCT","volume":"22","author":"Daniels","year":"2022","journal-title":"Health Technol Assess"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1016\/j.fertnstert.2005.05.074","article-title":"Uterine artery embolization versus myomectomy: a multicenter comparative study","volume":"85","author":"Goodwin","year":"2006","journal-title":"Fertil Steril"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"20220121","DOI":"10.1259\/bjr.20220121","article-title":"An update on uterine artery embolization for uterine leiomyomata and adenomyosis of the uterus","volume":"96","author":"Kr\u00f6ncke","year":"2023","journal-title":"Br J Radiol"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s11604-023-01492-1","article-title":"Efficacy of uterine artery embolization (UAE) for uterine fibroids according to FIGO classification: a single-center experience","volume":"42","author":"Ito","year":"2024","journal-title":"Jpn J Radiol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"906","DOI":"10.3390\/jpm13060906","article-title":"Uterine artery embolization for the treatment of symptomatic uterine fibroids of different sizes: a single Center experience","volume":"13","author":"Cappelli","year":"2023","journal-title":"J Pers Med"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/9781108332798.002","article-title":"Pathophysiology of uterine fibroids","volume-title":"Modern Management of Uterine Fibroids","author":"Otify","year":"2020"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"2786","DOI":"10.1007\/s43032-021-00722-z","article-title":"A systematic review of minimally invasive treatments for uterine fibroid-related bleeding","volume":"29","author":"Zhang","year":"2022","journal-title":"Reprod Sci"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1002\/ijgo.14626","article-title":"Effects on heavy menstrual bleeding and pregnancy of uterine artery embolization (UAE) or myomectomy for women with uterine fibroids wishing to avoid hysterectomy: the FEMME randomized controlled trial","volume":"160","author":"Sirkeci","year":"2023","journal-title":"Int J Gynaecol Obstet"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1382822\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T11:13:31Z","timestamp":1722942811000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1382822\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,6]]},"references-count":46,"alternative-id":["10.3389\/fmed.2024.1382822"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1382822","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,6]]},"article-number":"1382822"}}