Uterine AV malformation and treatment related Fertility outcome

The incidence and prevalence of uterine arteriovenous malformations (AVMs) is difficult to determine because bleeding caused by uterine AVMs does respond to medical management and several of these may go undiagnosed. Fewer than 100 cases have been reported in the literature, but the increased use of imaging modalities, particularly ultrasound in acute gynecology is likely to lead to identification of these lesions more frequently. Uterine AVMs are mainly acquired lesions, with pregnancy playing an important role in the pathogenesis. The most frequent clinical manifestation is abnormal uterine bleeding, which can often be episodic, heavy and can result in significant anemia or even shock. Hysterectomy remains the most definitive treatment; however, modern management of uterine AVMs includes medical management (hormonal therapy), minimally invasive surgery, uterine artery embolization and even Hysterectomy. As women who has AVM are largely from reproductive age group, effect of different treatment modalities especially uterine artery embolisation on fertility is still a subject of debate