Pregnancy Outcome After High Intensity Focused Ultrasound (HIFU) Ablation For Treatment Of Infertility Or Adverse Pregnancy History Women With Uterine Fibroids

Objective:To analysis the pregnancy outcome after high intensity focused ultrasound(HIFU) ablation for treatment of infertility or adverse pregnancy history women with uterine fibroids. And to evaluate the relevant factors that influence pregnancy rate after HIFU therapy.Methods:By means of retrospective studies of the 47 cases from April 1,2011 to Nov 1,2014 who underwent HIFU therapy at Chongqing Haifu Hospital.These patients were infertility or had adverse pregnancy history. We recorded and analyzed the demographic, history of gestation, leiomyoma characteristics, the non-perfused volume rate, the intensity of treatment,the time interval for conception after treatment, reproductive outcomes, et al. And there are a series of comparison of these factors between fertility and infertility patients after HIFU ablation.Result:1.The average age of 47 women is 34.5±4.8 years old(range:25-45).Among the 47 patients, 8 patients(38.3%) were diagnosed with infertility before the treatment, 26 patients(55.3%) with spontaneous abortion,1patients(2.1%) with stillbirth, 2 patients(4.3%) with the two failure after in-vitro fertilization.2.Pregnangcy rate is 44.7%(21/47) after after HIFU treatment,all is natural pregnancy, in which the live birth rate was 83.3%(20/24). The mean interval time between HIFU therapy and pregnancy was 8.0 ± 5.4months(range:1-18), and the interval time was less than 6 months theat71.4% patients Successfully conceived after HIFU. At the end of feb5,2016, 20 of pregnancies resulted in deliveries, and 1 is currently ongoing beyond 16 weeks. Among the 20 cases of pregnant women, 17 cases had full-term deliveries and 3 cases had premature deliveries. Among the 20 women, 2 women had a vaginal delivery, 18 women had cesarean delivery.Anyway, all babies were alive.Uterine rupture was nof found during pregnancy and labor.3.The pregnancy rate(61.5%) of the age ≤ 35 years patients with pregnancies after HIFU was significantly higher than that(23.8%) of the age >35 patients(p<0.05).The pregnancy rate was significantly different between two groups of normal(66.7%) or deformation(30%) of uterine cavity that was caused by intramural myoma. The non-perfused volumerate of the fertility patients after HIFU was 90%(80%, 98%) and the infertility group was 80%(74%, 80%), the difference was statistically significant(P < 0.05).The average intensity of treatment pregnancy group was 515.29±136.86 seconds / hour, non pregnant group was 647.92±209.50 seconds / hour, there was also significant difference(P < 0.05). But there is no obvious difference of history of gestation 、leiomyoma characteristics between the fertility and infertility group(P > 0.05).Conclusion:Based on our result, HIFU ablation for uterine fibroids can improve reproductive outcomes of the infertility and adverse pregnancy history.Age >35, deformation of uterine cavity that was pressured by intramural myoma, the lower non-perfused volume rate, the higher intensity of treatment show negative correlation with pregnancy rate after HIFU treatment.