Fibrosis is one of the hallmarks of leiomyomas, where dysregulated ECM plays a crucial role.30, 31 ECM such as collagen, fibronectin, laminins and proteoglycan are overexpressed in ULs, which induces mechanotransduction by integrin activation and increases tissue stiffness by altering bidirectional signalling.31 Here, FN1 is linked to fibrosis.