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Hum. Reprod. Advance Access published online on April 28, 2005
Human Reproduction, doi:10.1093/humrep/dei049
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received January 9, 2005
Revised February 19, 2005
Accepted March 22, 2005

Article

Familial prevalence of uterine fibroids is associated with distinct clinical and molecular features

S.O. Okolo 1*, C.C. Gentry 2, C.W. Perrett 3, and A.B. Maclean 3

1 Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London N18 1QX, UK and 2Department of Obstetrics and Gynaecology, Royal Free Campus, RFUCMS, London NW3 2PF, UK
2 Department of Obstetrics and Gynaecology, North Middlesex University Hospital, London N18 1QX, UK and 2Department of Obstetrics and Gynaecology, Royal Free Campus, RFUCMS, London NW3 2PF, UK
3 Department of Obstetrics and Gynaecology, Royal Free Campus, RFUCMS, London NW3 2PF, UK

* To whom correspondence should be addressed.
S.O. Okolo, E-mail: S.okolo{at}medsch.ucl.ac.uk


  Abstract

BACKGROUND: Although uterine fibroids are very common, their pathogenesis and clinical behaviour are poorly understood. Since they may be prevalent in some families, we investigated whether such a prevalence was associated with distinctive clinical and molecular features. METHODS: A case-control questionnaire study of 300 multi-ethnic women with uterine fibroids at a London university hospital was undertaken, with review of case notes and immunohistochemical determination of vascular endothelial growth factor (VEGF-A) in fibroids. RESULTS: When compared with families with sporadic fibroids, familial prevalence of fibroids was associated with a higher incidence of abdominal swelling (59.1% versus 41.6%; P=0.037), menorrhagia (84.4% versus 51.9%; P=0.042), dysmenorrhoea (64.4% versus 46.3%; P=0.004), dyspareunia (43.2% versus 27.9%; P=0.012) and family history of cancers (52.3% versus 32.4%; P<0.01). The fibroids were also more multiple (mean ± SEM: 7 ± 0.86 versus 3 ± 0.42; P<0.011) and strong VEGF-A expression in fibroids was more common in the familial group (64% versus 28%). Racial distribution was the same in both groups (blacks 49%, whites 33.4%, others 18.6%). CONCLUSIONS: Familial prevalence of uterine fibroids is associated with distinct clinical and molecular features that differ from those found when fibroids occur sporadically in families.

Keywords: angiogenesis; clinical features; familial prevalence; fibroids; VEGF-A.
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