Abstract
BACKGROUND: High-intensity focused ultrasound ablation has emerged as a noninvasive therapeutic option for adenomyosis of the uterus. We studied a female with infertility patient to explore the application of in vitro fertilization combined with high-intensity focused ultrasound treatment in patients with endometriosis complicated by adenomyosis. CASE PRESENTATION: A retrospective analysis of a 30-year-old Han Chinese woman with infertility complicated by both endometriosis and adenomyosis was performed, including pregnancy achieved through in vitro fertilization, downregulation using a gonadotropin-releasing hormone agonist, high-intensity focused ultrasound treatment and final pregnancy outcomes. The patient successfully conceived following the combined application of high-intensity focused ultrasound treatment and downregulation using a gonadotropin-releasing hormone agonist, with an intrauterine pregnancy confirmed in June 2025 and appropriate fetal development. CONCLUSION: The combined application of downregulation using a gonadotropin-releasing hormone agonist and high-intensity focused ultrasound treatment represents a promising therapeutic strategy for patients with infertility with concurrent endometriosis and adenomyosis. Nevertheless, prospective multi-centre studies remain essential to validate the long-term efficacy and safety profiles.