Women with fibroids and endometriosis facing the possibility of hysterectomy may now choose less invasive treatment options to preserve fertility, according to Yale professor Dr. Aydin Arici, who directed a scientific session exploring these alternatives at the American College of Obstetricians and Gynecologists (ACOG) Annual Clinical Meeting May 3-7 in New Orleans, Louisiana.
Arici chaired the two-day postgraduate ACOG course “Current Topics in Reproductive Endocrinology for the Clinician.” He joined colleagues in the Yale Department of Obstetrics, Gynecology & Reproductive Sciences (Yale Ob/Gyn) as they led other ACOG courses on menopause, managing post-term pregnancy and managing patients with bleeding disorders during pregnancy.
In his course, Arici presented treatment options for endometriosis and shared novel conservative approaches for treating fibroids, the most common benign tumor seen in reproductive-age women and the leading cause of hysterectomy in the United States.
“Our goal is to educate general obstetricians on ways to tailor new treatment techniques to the needs of individual patients,” said Arici. “For women in their 30s and 40s, preserving reproductive potential while treating fibroids is often desired. In the past, ovarian function was suppressed by inducing sudden menopause to shrink fibroids. Novel medications that were unavailable a few years back are now able to do so without unpleasant side effects.”
Arici said that conservative treatment options include a medical approach using selective estrogen receptor modulators and selective progesterone receptor modulators, uterine artery embolization, MRI-focused high-energy ultrasound, and conservative surgery using abdominal myomectomy, hysterectomy to remove the fibroids, but preserve the reproductive capacity of the uterus.
Yale Ob/Gyn reproductive endocrinologist Lubna Pal’s ACOG course explored the biological, psychosocial and behavioral consequences of women’s transition into menopause and the postmenopausal years. One of her goals is to help doctors understand the predictors of menopause, and the treatment needs of women who have undergone hysterectomies or oophorectomies.
Dr. Errol Norwitz led an interactive session on managing post-term or overdue pregnancies. He and his colleagues addressed issues such as the risks and benefits of routine induction of labor at 41 weeks gestation.
Dr. Charles Lockwood, chair of Yale Ob/Gyn, and Dr. Michael Paidas, associate professor, led an interactive session on bleeding disorders during pregnancy.
Other current and former Yale faculty members teaching courses at ACOG included Susan Richman, Steven Fleischman, Rebecca Pschirrer, John Hobbins, Al Reece, Monique Chireau, Robert Graeve, John Larsen, Thomas Moore, Donald Goustan and Alessandro Ghidini.
The work above was funded, fully or in part, by the Yale Clinical and Translational Science Award (CTSA) grant from the National Center for Research Resources at the National Institutes of Health.
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