HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment
AbstractObjectives To compare pregnancy outcomes after high-intensity focused ultrasound ablation (HIFU), myomectomy and uterine artery embolization (UAE) for fertility-sparing patients with uterine fibroids and to investigate the possible mechanism of improving pregnancy by HIFU.Materials and metho...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2023-12-01
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| Series: | International Journal of Hyperthermia |
| Subjects: | |
| Online Access: | https://www.tandfonline.com/doi/10.1080/02656736.2022.2155077 |
| _version_ | 1797374236816310272 |
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| author | Fang Li Jing Chen Li Yin Dingyuan Zeng Li Wang Hua Tao Xiajuan Wu Feng Wei Fan Xu Qiuling Shi Zhong Lin Zhibiao Wang |
| author_facet | Fang Li Jing Chen Li Yin Dingyuan Zeng Li Wang Hua Tao Xiajuan Wu Feng Wei Fan Xu Qiuling Shi Zhong Lin Zhibiao Wang |
| author_sort | Fang Li |
| collection | DOAJ |
| description | AbstractObjectives To compare pregnancy outcomes after high-intensity focused ultrasound ablation (HIFU), myomectomy and uterine artery embolization (UAE) for fertility-sparing patients with uterine fibroids and to investigate the possible mechanism of improving pregnancy by HIFU.Materials and methods A meta-analysis of 54 studies containing 12,367 patients was conducted to compare the pregnancy outcomes of three fertility-sparing therapies. And a retrospective self-control study of 26 patients with uterine fibroids from May 2019 to December 2020 was performed to assess the blood flow impedance of bilateral uterine arteries before and after HIFU.Results In the analysis by treatment option, the pregnancy rate after myomectomy was 0.43 (95% CI 0.36–0.49), which was higher than 0.18 (95% CI 0.10–0.26) after HIFU, the latter was significantly higher than that after UAE (ratio 0.08, 95% CI 0.06–0.10). The miscarriage rate after HIFU was 0.08 (95% CI 0.04–0.12), which was similar to 0.15 (95% CI 0.09–0.21) after myomectomy and also similar to 0.16 after UAE (95% CI 0.01–0.30). In the subgroup analysis, women who received ultrasound guided HIFU (USgHIFU) were more likely to have ideal pregnancy outcomes than that after magnetic resonance imaging-guided HIFU. The pulsatility index and resistance index on the right side were significantly higher 3 months after HIFU than before (1.637 ± 0.435 vs. 1.845 ± 0.469; p = 0.033; 0.729 ± 0.141 vs. 0.784 ± 0.081, p = 0.039).Conclusions HIFU, especially USgHIFU, may be an alternative fertility-sparing modality for patients with uterine fibroids over 40 years old. HIFU may contribute to improving pregnancy rates by elevating uterine blood flow impedance. |
| first_indexed | 2024-03-08T19:03:01Z |
| format | Article |
| id | doaj.art-973d502d455145b4b34179e32fb571d1 |
| institution | Directory Open Access Journal |
| issn | 0265-6736 1464-5157 |
| language | English |
| last_indexed | 2024-03-08T19:03:01Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | International Journal of Hyperthermia |
| spelling | doaj.art-973d502d455145b4b34179e32fb571d12023-12-28T04:15:42ZengTaylor & Francis GroupInternational Journal of Hyperthermia0265-67361464-51572023-12-0140110.1080/02656736.2022.2155077HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatmentFang Li0Jing Chen1Li Yin2Dingyuan Zeng3Li Wang4Hua Tao5Xiajuan Wu6Feng Wei7Fan Xu8Qiuling Shi9Zhong Lin10Zhibiao Wang11State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaXiamen Maluan Bay Hospital, Xiamen, ChinaLiuzhou Maternity and Child Healthcare Hospital, Affiliated Women and Children’s Hospital of Guangxi University of Science and Technology, Liuzhou, ChinaLiuzhou Maternity and Child Healthcare Hospital, Affiliated Women and Children’s Hospital of Guangxi University of Science and Technology, Liuzhou, ChinaLiuzhou Maternity and Child Healthcare Hospital, Affiliated Women and Children’s Hospital of Guangxi University of Science and Technology, Liuzhou, ChinaLiuzhou Maternity and Child Healthcare Hospital, Affiliated Women and Children’s Hospital of Guangxi University of Science and Technology, Liuzhou, ChinaLiuzhou Maternity and Child Healthcare Hospital, Affiliated Women and Children’s Hospital of Guangxi University of Science and Technology, Liuzhou, ChinaNanchong Central Hospital, North Sichuan Medical University, Nanchong, ChinaState Key Laboratory of Ultrasound Engineering in Medicine, School of Public Health, Chongqing Medical University, Chongqing, ChinaThe Reproductive Hospital of Guangxi Zhuang Autonomous Region, ChinaState Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, ChinaAbstractObjectives To compare pregnancy outcomes after high-intensity focused ultrasound ablation (HIFU), myomectomy and uterine artery embolization (UAE) for fertility-sparing patients with uterine fibroids and to investigate the possible mechanism of improving pregnancy by HIFU.Materials and methods A meta-analysis of 54 studies containing 12,367 patients was conducted to compare the pregnancy outcomes of three fertility-sparing therapies. And a retrospective self-control study of 26 patients with uterine fibroids from May 2019 to December 2020 was performed to assess the blood flow impedance of bilateral uterine arteries before and after HIFU.Results In the analysis by treatment option, the pregnancy rate after myomectomy was 0.43 (95% CI 0.36–0.49), which was higher than 0.18 (95% CI 0.10–0.26) after HIFU, the latter was significantly higher than that after UAE (ratio 0.08, 95% CI 0.06–0.10). The miscarriage rate after HIFU was 0.08 (95% CI 0.04–0.12), which was similar to 0.15 (95% CI 0.09–0.21) after myomectomy and also similar to 0.16 after UAE (95% CI 0.01–0.30). In the subgroup analysis, women who received ultrasound guided HIFU (USgHIFU) were more likely to have ideal pregnancy outcomes than that after magnetic resonance imaging-guided HIFU. The pulsatility index and resistance index on the right side were significantly higher 3 months after HIFU than before (1.637 ± 0.435 vs. 1.845 ± 0.469; p = 0.033; 0.729 ± 0.141 vs. 0.784 ± 0.081, p = 0.039).Conclusions HIFU, especially USgHIFU, may be an alternative fertility-sparing modality for patients with uterine fibroids over 40 years old. HIFU may contribute to improving pregnancy rates by elevating uterine blood flow impedance.https://www.tandfonline.com/doi/10.1080/02656736.2022.2155077HIFUfertility-sparing treatmentpregnancy outcomesuterine fibroidsblood flow impedance |
| spellingShingle | Fang Li Jing Chen Li Yin Dingyuan Zeng Li Wang Hua Tao Xiajuan Wu Feng Wei Fan Xu Qiuling Shi Zhong Lin Zhibiao Wang HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment International Journal of Hyperthermia HIFU fertility-sparing treatment pregnancy outcomes uterine fibroids blood flow impedance |
| title | HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment |
| title_full | HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment |
| title_fullStr | HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment |
| title_full_unstemmed | HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment |
| title_short | HIFU as an alternative modality for patients with uterine fibroids who require fertility-sparing treatment |
| title_sort | hifu as an alternative modality for patients with uterine fibroids who require fertility sparing treatment |
| topic | HIFU fertility-sparing treatment pregnancy outcomes uterine fibroids blood flow impedance |
| url | https://www.tandfonline.com/doi/10.1080/02656736.2022.2155077 |
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