Comparison of reproductive outcomes after ultrasound-guided high-intensity focused ultrasound and myomectomy for patients with uterine fibroids.

OBJECTIVE

To compare the reproductive outcomes in patients with uterine fibroids (UFs) after ultrasound-guided high-intensity focused ultrasound (USgHIFU) and myomectomy, and to evaluate reproductive outcomes after re-intervention following initial USgHIFU.

MATERIALS AND

METHODS

In this retrospective study, women who underwent USgHIFU or myomectomy between January 2012 and December 2019 and subsequently conceived were enrolled. Propensity-score matching (PSM) was applied to balance baseline characteristics.

RESULTS

After PSM, the Group A (patients underwent single USgHIFU ablation) and Group MY (patients underwent myomectomy) were designated as Group A1 (81 women with 90 pregnancies) and Group MY1 (81 women with 93 pregnancies), as well as Group A and Group B (patients underwent re-intervention following USgHIFU) were designated as Group A2 (41 patients with 47 pregnancies) and Group B2 (41 patients with 45 pregnancies). No significant differences were observed in parturition rates (64.4% vs. 57.0%), spontaneous abortion rate (12.2% vs. 7.5%) or pregnancy complication rates between Group A1 and Group MY1 (p > 0.05). Group A1 exhibited a higher pregnancy rate within 1 year (35.6% vs. 24.7%) and a lower cesarean section rate (74.1% vs. 83.0%) than Group MY1, without significant differences (p > 0.05). Besides, no significant differences were found between Group A2 and Group B2 in reproductive outcomes (p > 0.05).

CONCLUSION

Reproductive outcomes after USgHIFU were comparable to those after myomectomy. USgHIFU is a viable option for patients with fertility requirements and may also serve as a means to control the progression of UFs in patients without immediate pregnancy plans.