Treatment of leiomyomata uteri with leuprolide acetate depot: a double-blind, placebo-controlled, multicenter study

Article Abstract:

Uterine leiomyomata are fiber-like tumors of the smooth muscle in the uterus that are sensitive to the female hormone estrogen. These tumors occur in 25 percent of women of childbearing age. An increase in the size of the uterus and excessive menstrual bleeding may develop in 20 to 50 percent of women with leiomyomata uteri. These symptoms may be treated with gonadotropin-releasing hormone agonists, which inhibit the release of hormones that stimulate the ovaries or testes. The effectiveness and safety of the gonadotropin-releasing hormone agonist leuprolide acetate were assessed in 128 patients with leiomyomata uteri. The drug was administered in doses of 3.75 milligrams into the muscle every four weeks for 24 weeks. Leuprolide treatment decreased the volume of the uterus by 36 percent at 12 weeks and 45 percent at 24 weeks. In patients given a placebo, which has no therapeutic effect, the uterine volume decreased by 16 percent at 12 weeks and five percent by 24 weeks. A decrease in uterine volume of 25 percent was achieved in 77 percent of leuprolide-treated patients and nine percent of patients given a placebo. However, the volume of the uterus returned to its size before drug therapy within 24 weeks of discontinuing leuprolide treatment. Symptoms of leiomyomata uteri resolved or improved after 24 weeks of leuprolide treatment. Leuprolide improved menorrhagia, or heavy bleeding, in 37 of 38 patients. Side effects of leuprolide acetate occurred in 95 percent of drug-treated patients, but only five patients discontinued drug therapy during the study. These findings show that leuprolide acetate is both safe and effective in transiently reducing the size of the uterus and symptoms of fibroid tumors in patients with leiomyomata uteri. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Drug therapy, Menorrhagia, Uterine fibroids

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Adjunctive leuprolide therapy does not improve cycle fecundity in controlled ovarian hyperstimulation and intrauterine insemination of subfertile women

Article Abstract:

Subfertility, or reduced ability to become pregnant, can be improved using various fertilization methods. These include in vitro fertilization-embryo transfer (IVF-ET) and gamete intrafallopian transfer (GIFT). In IVF-ET, the egg is fertilized outside of the body, and the resulting embryo is transferred back into the uterus. In GIFT, the egg and sperm are removed from the body, and examined for viability, or ability to survive. The viable egg and sperm are then placed into the fallopian tubes, which connect the ovaries to the uterus, and permitted to fertilize within the body. Both fertilization methods require agents that stimulate the ovaries to produce eggs, such as human menopausal gonadotropins (hMGs). However, overstimulation of the ovaries may also disturb the natural cycle of egg development and release from the ovaries, and adversely affect fertilization. Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide acetate, are drugs that control the production of eggs by the ovary and thereby increase the efficiency of GIFT and IVF-ET. Intrauterine insemination is another method of fertilization, in which sperm in injected into the uterus. This procedure also requires treatment by agents that stimulate the ovaries, and hence may also be complicated by disturbances in the ovarian cycle. The effect of leuprolide acetate on the efficiency of intrauterine insemination with controlled ovarian hyperstimulation by hMG was assessed in 97 subfertile women. The results showed that the addition of leuprolide to the regimen did not improve the fecundity, or productivity, of the ovaries. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Infertility, Female, Female infertility, Artificial insemination

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Successful treatment of a persistent cyst, developing after ovarian transposition, with leuprolide acetate

Article Abstract:

When women undergo hysterectomy for treatment of cervical cancer, their ovaries may be transposed (moved to a different location) in order to remove them from the field of radiation therapy. This is especially important in the cases of young women, who want to preserve ovarian and sexual function. Transposed ovaries, however, tend to develop cysts, which can cause pain. In such cases, hormonal treatment can be instituted. The report is presented of a 42-year-old patient with cervical cancer whose right ovary was transposed to another site in the abdomen during a hysterectomy and salpingoopherectomy (removal of the left ovary and tube). Nine months later, the patient developed pain in the right side and back. A cystic mass was identified, and treatment was started with leuprolide acetate (which lowers the concentration of hormones that stimulate the ovaries). Four weeks later, the cyst had vanished, and ovarian function returned to normal. The advantages of agents such as leuprolide acetate (gonadotropin releasing hormone agonists) to treat cysts after ovarian transposition are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Surgery, Cervical cancer, Ovaries, Ovarian cysts, Cysts

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