Department of ultrasound, Wuxi No.2 People's Hospital, Affiliated Hospital of Nanjing Medical University, Wuxi City, China.
Department of ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
J Clin Ultrasound. 2022 Feb;50(2):202-208. doi: 10.1002/jcu.23116. Epub 2021 Dec 29.
To investigate the ovarian function and pregnancy outcome of patients with uterine fibroids and the influencing factors after high intensity focused ultrasound (HIFU) ablation treatment.
A total of 80 patients were recruited. All patients were divided into the pregnancy group (64 cases) and the non-pregnancy group (16 cases). The pregnancy group was categorized into the good pregnancy outcome (GOP) group (46 cases) and adverse pregnancy outcome (APO) group (18 cases). The general data of all study subjects were collected. The changes of anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), inhibin B (INHB), and antral follicle count (AFC) before HIFU and 3, 6, and 12 months after HIFU were compared. The related factors affecting pregnancy and pregnancy outcomes were analyzed.
There were no significant differences in AMH, FSH, INHB levels, and AFC at 6 and 12 months after HIFU compared with those before HIFU in pregnancy and non-pregnancy groups (p > 0.05). This study demonstrated that patients with prior history of pregnancy, younger age, lower body mass index (BMI), and smaller fibroids volume had a higher pregnancy rate (p < 0.05). Besides, younger age and smaller fibroids volume were associated with better pregnancy outcomes (p < 0.05).
HIFU in the treatment of uterine fibroids has little effect on ovarian function and does not increase the risk of infertility and adverse pregnancy. The prior history of pregnancy, age, BMI, and fibroids volume are essential factors affecting the postoperative pregnancy.
探讨高强度聚焦超声（HIFU）消融治疗后子宫肌瘤患者的卵巢功能和妊娠结局及其影响因素。
共纳入 80 例患者。所有患者均分为妊娠组（64 例）和非妊娠组（16 例）。妊娠组再分为良好妊娠结局（GOP）组（46 例）和不良妊娠结局（APO）组（18 例）。收集所有研究对象的一般资料。比较所有研究对象 HIFU 治疗前及 HIFU 治疗后 3、6、12 个月时抗苗勒管激素（AMH）、卵泡刺激素（FSH）、抑制素 B（INHB）和窦卵泡计数（AFC）的变化，并分析影响妊娠和妊娠结局的相关因素。
妊娠组和非妊娠组 HIFU 治疗后 6、12 个月时 AMH、FSH、INHB 水平和 AFC 与 HIFU 治疗前比较，差异均无统计学意义（p>0.05）。本研究表明，有妊娠史、年龄较小、体质量指数（BMI）较低、肌瘤体积较小的患者妊娠率较高（p<0.05）。此外，年龄较小和肌瘤体积较小与较好的妊娠结局相关（p<0.05）。
HIFU 治疗子宫肌瘤对卵巢功能影响较小，不会增加不孕和不良妊娠的风险。妊娠史、年龄、BMI 和肌瘤体积是影响术后妊娠的重要因素。
