Reproductive outcomes of high-intensity focused ultrasound ablation and myomectomy for uterine fibroids: a systematic review and meta-analysis
Does high-intensity focused ultrasound (HIFU) ablation have comparable reproductive outcomes to myomectomy for patients with uterine fibroids? A systematic review and a meta-analysis of data extracted from published studies up to March 2024. Through a more structured analysis, HIFU treatment yielded...
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Veröffentlicht in: | Reproductive biomedicine online 2025-01, Vol.50 (1), p.104436, Article 104436 |
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description | Does high-intensity focused ultrasound (HIFU) ablation have comparable reproductive outcomes to myomectomy for patients with uterine fibroids?
A systematic review and a meta-analysis of data extracted from published studies up to March 2024.
Through a more structured analysis, HIFU treatment yielded a pooled pregnancy rate of 23.3% (95% CI 11.5 to 37.6%) and a pooled live birth rate (LBR) of 17.3% (95% CI 7.8 to 29.3%), significantly lower than those after myomectomy, which had a pooled pregnancy rate of 56.9% (95% CI 45.6 to 67.9%) and a pooled LBR of 44.1% (95% CI 34.9 to 53.4%) (P = 0.0001 and P = 0.0003, respectively). After controlling for patient age, ultrasound-guided HIFU studies reported significantly lower pregnancy rate and LBR compared with myomectomy. Moreover, studies enrolling younger patients and explicitly recruiting those desiring to conceive reported better reproductive outcomes.
Patients with uterine fibroids undergoing HIFU treatment and desiring to preserve their uteri resulted in poorer reproductive outcomes compared with myomectomy. Although uterine fibroids are now the number one disease that receives HIFU treatment worldwide, the overall quality in design and execution of HIFU studies on reproductive outcomes for women with uterine fibroids leaves much room for improvement. Above all, comparative trials against the standard of care are badly needed. |
doi_str_mv | 10.1016/j.rbmo.2024.104436 |
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A systematic review and a meta-analysis of data extracted from published studies up to March 2024.
Through a more structured analysis, HIFU treatment yielded a pooled pregnancy rate of 23.3% (95% CI 11.5 to 37.6%) and a pooled live birth rate (LBR) of 17.3% (95% CI 7.8 to 29.3%), significantly lower than those after myomectomy, which had a pooled pregnancy rate of 56.9% (95% CI 45.6 to 67.9%) and a pooled LBR of 44.1% (95% CI 34.9 to 53.4%) (P = 0.0001 and P = 0.0003, respectively). After controlling for patient age, ultrasound-guided HIFU studies reported significantly lower pregnancy rate and LBR compared with myomectomy. Moreover, studies enrolling younger patients and explicitly recruiting those desiring to conceive reported better reproductive outcomes.
Patients with uterine fibroids undergoing HIFU treatment and desiring to preserve their uteri resulted in poorer reproductive outcomes compared with myomectomy. Although uterine fibroids are now the number one disease that receives HIFU treatment worldwide, the overall quality in design and execution of HIFU studies on reproductive outcomes for women with uterine fibroids leaves much room for improvement. Above all, comparative trials against the standard of care are badly needed.</description><identifier>ISSN: 1472-6483</identifier><identifier>ISSN: 1472-6491</identifier><identifier>EISSN: 1472-6491</identifier><identifier>DOI: 10.1016/j.rbmo.2024.104436</identifier><identifier>PMID: 39616958</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>High-intensity focused ultrasound ; Live birth rate ; Miscarriage rate ; Myomectomy ; Pregnancy rate ; Uterine fibroids</subject><ispartof>Reproductive biomedicine online, 2025-01, Vol.50 (1), p.104436, Article 104436</ispartof><rights>2024 Reproductive Healthcare Ltd.</rights><rights>Copyright © 2024 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c237t-c469547ffaaa1c770c57236faca7e19fa2fecf79587443cb15a695d70120348a3</cites><orcidid>0000-0002-8511-7624</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.rbmo.2024.104436$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39616958$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Yishan</creatorcontrib><creatorcontrib>Yi, Jingsong</creatorcontrib><creatorcontrib>Lin, Shunhe</creatorcontrib><creatorcontrib>Xie, Xi</creatorcontrib><creatorcontrib>Liu, Xishi</creatorcontrib><creatorcontrib>Guo, Sun-Wei</creatorcontrib><title>Reproductive outcomes of high-intensity focused ultrasound ablation and myomectomy for uterine fibroids: a systematic review and meta-analysis</title><title>Reproductive biomedicine online</title><addtitle>Reprod Biomed Online</addtitle><description>Does high-intensity focused ultrasound (HIFU) ablation have comparable reproductive outcomes to myomectomy for patients with uterine fibroids?
A systematic review and a meta-analysis of data extracted from published studies up to March 2024.
Through a more structured analysis, HIFU treatment yielded a pooled pregnancy rate of 23.3% (95% CI 11.5 to 37.6%) and a pooled live birth rate (LBR) of 17.3% (95% CI 7.8 to 29.3%), significantly lower than those after myomectomy, which had a pooled pregnancy rate of 56.9% (95% CI 45.6 to 67.9%) and a pooled LBR of 44.1% (95% CI 34.9 to 53.4%) (P = 0.0001 and P = 0.0003, respectively). After controlling for patient age, ultrasound-guided HIFU studies reported significantly lower pregnancy rate and LBR compared with myomectomy. Moreover, studies enrolling younger patients and explicitly recruiting those desiring to conceive reported better reproductive outcomes.
Patients with uterine fibroids undergoing HIFU treatment and desiring to preserve their uteri resulted in poorer reproductive outcomes compared with myomectomy. Although uterine fibroids are now the number one disease that receives HIFU treatment worldwide, the overall quality in design and execution of HIFU studies on reproductive outcomes for women with uterine fibroids leaves much room for improvement. Above all, comparative trials against the standard of care are badly needed.</description><subject>High-intensity focused ultrasound</subject><subject>Live birth rate</subject><subject>Miscarriage rate</subject><subject>Myomectomy</subject><subject>Pregnancy rate</subject><subject>Uterine fibroids</subject><issn>1472-6483</issn><issn>1472-6491</issn><issn>1472-6491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQhSMEakvpC7BAXrLJxY594wSxQVVLK1VCQrC2Js6Y-iqJi8cuykvwzPgqpUtW_tH5RnPOqaq3gu8EF-2Hwy4Oc9g1vFHlQynZvqjOhNJN3apevHy-d_K0ek104Fx0vJMn1ansW9H2--6s-vMNH2IYs03-EVnIyYYZiQXH7v3P-9ovCRfyaWUu2Ew4sjylCBTyMjIYJkg-LAzKY14LaFOYj9LIcsLoF2TODzH4kT4yYLRSwrkglkV89Ph7AzFBDQtMK3l6U71yMBFePJ3n1Y_rq--XN_Xd1y-3l5_vattInWqryvZKOwcAwmrN7V43snVgQaPoHTQOrdPFoS6x2EHsoQCj5qLhUnUgz6v329xi_ldGSmb2ZHGaYMGQyUiheNfLVsoibTapjYEoojMP0c8QVyO4OfZgDubYgzn2YLYeCvTuaX4eZhyfkX_BF8GnTYDFZckiGrIeF4ujjyVGMwb_v_l_AarYnVI</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Chen, Yishan</creator><creator>Yi, Jingsong</creator><creator>Lin, Shunhe</creator><creator>Xie, Xi</creator><creator>Liu, Xishi</creator><creator>Guo, Sun-Wei</creator><general>Elsevier Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8511-7624</orcidid></search><sort><creationdate>20250101</creationdate><title>Reproductive outcomes of high-intensity focused ultrasound ablation and myomectomy for uterine fibroids: a systematic review and meta-analysis</title><author>Chen, Yishan ; Yi, Jingsong ; Lin, Shunhe ; Xie, Xi ; Liu, Xishi ; Guo, Sun-Wei</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c237t-c469547ffaaa1c770c57236faca7e19fa2fecf79587443cb15a695d70120348a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>High-intensity focused ultrasound</topic><topic>Live birth rate</topic><topic>Miscarriage rate</topic><topic>Myomectomy</topic><topic>Pregnancy rate</topic><topic>Uterine fibroids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Yishan</creatorcontrib><creatorcontrib>Yi, Jingsong</creatorcontrib><creatorcontrib>Lin, Shunhe</creatorcontrib><creatorcontrib>Xie, Xi</creatorcontrib><creatorcontrib>Liu, Xishi</creatorcontrib><creatorcontrib>Guo, Sun-Wei</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Reproductive biomedicine online</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Yishan</au><au>Yi, Jingsong</au><au>Lin, Shunhe</au><au>Xie, Xi</au><au>Liu, Xishi</au><au>Guo, Sun-Wei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reproductive outcomes of high-intensity focused ultrasound ablation and myomectomy for uterine fibroids: a systematic review and meta-analysis</atitle><jtitle>Reproductive biomedicine online</jtitle><addtitle>Reprod Biomed Online</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>50</volume><issue>1</issue><spage>104436</spage><pages>104436-</pages><artnum>104436</artnum><issn>1472-6483</issn><issn>1472-6491</issn><eissn>1472-6491</eissn><abstract>Does high-intensity focused ultrasound (HIFU) ablation have comparable reproductive outcomes to myomectomy for patients with uterine fibroids?
A systematic review and a meta-analysis of data extracted from published studies up to March 2024.
Through a more structured analysis, HIFU treatment yielded a pooled pregnancy rate of 23.3% (95% CI 11.5 to 37.6%) and a pooled live birth rate (LBR) of 17.3% (95% CI 7.8 to 29.3%), significantly lower than those after myomectomy, which had a pooled pregnancy rate of 56.9% (95% CI 45.6 to 67.9%) and a pooled LBR of 44.1% (95% CI 34.9 to 53.4%) (P = 0.0001 and P = 0.0003, respectively). After controlling for patient age, ultrasound-guided HIFU studies reported significantly lower pregnancy rate and LBR compared with myomectomy. Moreover, studies enrolling younger patients and explicitly recruiting those desiring to conceive reported better reproductive outcomes.
Patients with uterine fibroids undergoing HIFU treatment and desiring to preserve their uteri resulted in poorer reproductive outcomes compared with myomectomy. Although uterine fibroids are now the number one disease that receives HIFU treatment worldwide, the overall quality in design and execution of HIFU studies on reproductive outcomes for women with uterine fibroids leaves much room for improvement. Above all, comparative trials against the standard of care are badly needed.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>39616958</pmid><doi>10.1016/j.rbmo.2024.104436</doi><orcidid>https://orcid.org/0000-0002-8511-7624</orcidid></addata></record> |
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source | ScienceDirect Journals (5 years ago - present) |
subjects | High-intensity focused ultrasound Live birth rate Miscarriage rate Myomectomy Pregnancy rate Uterine fibroids |
title | Reproductive outcomes of high-intensity focused ultrasound ablation and myomectomy for uterine fibroids: a systematic review and meta-analysis |
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