EFFECTS OF MR-GUIDED AND ULTRASOUND-GUIDED FOCUSED ULTRASOUND TREATMENT FOR ADENOMYOSIS ON OVARIAN RESERVE ASSESSED BY ANTI-MÜLLERIAN HORMONE LEVELS: A NARRATIVE REVIEW

Kornelia Julia Fimiarz, Kinga Łysak, Sonia Pawełkiewicz, Irmina Grygutis, Aleksandra Suchołbiak, Urszula Jarzęcka, Kaja Kozielec, Maja Kozielec
In: International Journal of Innovative Technologies in Social Science · 2026 · vol. 5(2(50)) · doi:10.31435/ijitss.2(50).2026.5360 · W7204260556
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This narrative review finds that MR-guided and ultrasound-guided focused ultrasound treatments for adenomyosis do not significantly alter anti-Müllerian hormone levels, suggesting these techniques preserve ovarian reserve.

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This narrative review evaluates existing evidence regarding the impact of magnetic resonance-guided and ultrasound-guided high-intensity focused ultrasound treatments on ovarian reserve in women with adenomyosis. The authors analyzed prospective, retrospective, and randomized studies to determine changes in anti-Müllerian hormone levels following these localized thermal ablation procedures. Results from available literature indicate that neither treatment method causes significant alterations in AMH concentrations, suggesting that ovarian function is preserved compared to more invasive surgical options. However, the authors note limitations including small sample sizes, heterogeneous populations, and short follow-up periods across the reviewed studies. This paper is centrally about adenomyosis — specifically assessing the safety of focal ultrasound therapies for this condition in relation to fertility preservation.

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Abstract

Aim: This narrative review evaluates the current evidence on the impact of high-intensity focused ultrasound (HIFU), including MR-guided (MRgFUS) and ultrasound-guided (USgHIFU) techniques, on ovarian reserve in women treated for adenomyosis, with particular emphasis on anti-Müllerian hormone (AMH) level. Methods: narrative review included evidence from prospective and retrospective studies, randomized trials, and original research in patients with adenomyosis, identified through searches of PubMed/MEDLINE, Embase, Web of Science, and Google Scholar. Results: available studies consistently demonstrate that this treatment does not result in significant changes in AMH concentrations, irrespective of the method used, suggesting preservation of ovarian reserve. Conclusion: In contrast to more invasive treatment options, such as uterine artery embolization or hysterectomy, HIFU acts locally, minimizing the risk of damage to ovarian tissue and vascular supply. This enables the preservation of fertility, which is particularly important for women desiring future childbearing. However, the available evidence is limited by small sample sizes, heterogeneous study populations, and short follow-up periods. Further large-scale, prospective studies with long-term follow-up are needed to confirm the sustained safety of HIFU and its impact on reproductive outcomes.
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Methods

narrative review included evidence from prospective and retrospective studies, randomized trials, and original research in patients with adenomyosis, identified through searches of PubMed/MEDLINE, Embase, Web of Science, and Google Scholar.

Results

available studies consistently demonstrate that this treatment does not result in significant changes in AMH concentrations, irrespective of the method used, suggesting preservation of ovarian reserve.

Conclusion

In contrast to more invasive treatment options, such as uterine artery embolization or hysterectomy, HIFU acts locally, minimizing the risk of damage to ovarian tissue and vascular supply. This enables the preservation of fertility, which is particularly important for women desiring future childbearing. However, the available evidence is limited by small sample sizes, heterogeneous study populations, and short follow-up periods. Further large-scale, prospective studies with long-term follow-up are needed to confirm the sustained safety of HIFU and its impact on reproductive outcomes.

References

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Biomolecules, 14(11), 1402. https://doi.org/10.3390/biom14111402 Downloads Published Issue Section License Copyright (c) 2026 Kornelia Julia Fimiarz, Kinga Łysak, Sonia Pawełkiewicz, Irmina Grygutis, Aleksandra Suchołbiak, Urszula Jarzęcka, Kaja Kozielec, Maja Kozielec This work is licensed under a Creative Commons Attribution 4.0 International License. All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles. CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

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