The Impact of High-Intensity Focused Ultrasound Ablation and Laparoscopic Myomectomy on Ovarian Function in Patients with Uterine Fibroids

高强度聚焦超声消融术和腹腔镜子宫肌瘤切除术对子宫肌瘤患者卵巢功能的影响

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Abstract

PURPOSE: To explore the value of high-intensity focused ultrasound (HIFU) ablation and laparoscopic myomectomy (LM) in the treatment of uterine fibroids. METHODS: One hundred and twenty patients with uterine fibroids admitted to our hospital from October 2020 to September 2022 and were conducted a randomized controlled trial and randomly assigned to two groups, with 60 cases each. The uterine fibroid surgery group is divided into LM group and HIFU ablation group. The healthy control group consisted of 60 cases. Ovarian function evaluations were conducted at four time points before surgery, 6 months after surgery, 1 year, and 2 years. The final follow-up assessment was conducted in September 2024. The ovarian function changes and complication in HIFU and LM groups were compared. RESULTS: The AMH levels and AFC counts of the HIFU group at 6 months after surgery were (2.39±0.35) ng/mL and (6.85±1.06), which were higher than those of the LM group (2.15±0.27) ng/mL and (6.02±0.87), respectively, with statistical differences (P<0.05). The incidence of HIFU complications was lower than that of the LM group, with statistical differences (P<0.05). Upon further statistical analysis of relevant indicators at 1 and 2 years post-surgery for the two surgical methods, no statistical differences were observed between AMH and AFC. CONCLUSION: After HIFU ablation for uterine fibroids in women aged 35-40, ovarian function was not significantly affected in the short term (6 months after surgery) and the long term (2 years after surgery). Compared to LM, HIFU ablation is more effective in treating uterine fibroids, reducing the impact on patients' ovarian function with fewer complications, and improving their quality of life.

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