Fertility and ulipristal acetate case report of two spontaneous pregnancies in the same patient following one cycle of treatment

Abstract

Ulipristal acetate (UPA) is an oral selective progesterone receptor modulator. It is one of the most recent alternatives in the management of symptomatic fibroids and its safety and effectiveness have already been demonstrated in several studies. Nevertheless, there is few evidence regarding its use in the subgroup of women who experience fertility issues and desire to conceive. The authors report a case of a 39- years-old woman with abnormal uterine bleeding and anemia. She had had an uncomplicated pregnancy some years before and was trying to have a second child. She was treated for 3 months with UPA, at a daily dose of 5 mg, per os, followed by a ressectoscopic myomectomy. After five months, she conceived spontaneously and had an uneventful pregnancy. She then remained asymptomatic and almost two years after she was pregnant again. This case supports the idea that UPA is a valid alternative in patients still have a desire to conceive and thus want to avoid surgery. Even tough larger studies on the subject are required, UPA may become very important role in the management of fibroids in the infertility context.