Abstract
OBJECTIVES: The objective is to analyze factors influencing pregnancy outcomes in patients with uterine fibroids after high-intensity focused ultrasound (HIFU) treatment. MATERIALS AND METHODS: Patients with uterine fibroids who wished to have children underwent HIFU treatment at Chongqing Haifu Hospital from April 2011 to May 2024 were retrospectively reviewed. HIFU treatment results were evaluated using magnetic resonance imaging, and the postoperative pregnancy outcomes were evaluated. RESULTS: 302 out of 748 (40.4%) patients became pregnant after HIFU, including 88.1% (273/310) in natural and 11.9% (37/310) in assisted reproduction. At the end of follow-up, 273 patients had 281 successful deliveries. No patient had a uterine rupture during pregnancy or delivery after HIFU. Patients with multiple fibroids had a lower probability of conception compared to those with a single fibroid (odds ratio [OR] >1, P < 0.05). A larger NPV ratio was associated with a higher likelihood of pregnancy (OR > 1, P < 0.05). Submucosal fibroids were an independent risk factor for pregnancy compared to subserosal fibroids (OR > 1, P < 0.05). In contrast, intramural or mixed-type fibroids were independent protective factors for pregnancy compared to submucosal fibroids (OR < 1, P < 0.05). A significant difference in NPV ratio and number of fibroids was also observed between patients in the delivery group and the miscarriage group (P < 0.05). CONCLUSION: HIFU treatment is safe and effective for patients with uterine fibroids who wish to have a child. Older age, multiple fibroids, submucosal fibroids, and low NPV have negative effects on pregnancy.