Effect of pelvic adhesions on reproductive outcomes following high-intensity focused ultrasound in patients with adenomyosis

Jin-Feng Lin, Jinfeng Lin, Lin JF, Yang ZY, Zhiyun Yang, Zhi-Yun Yang, Tao Tan, Tan T, Wang L, Lu Wang, Zhibo Xiao, Xiao ZB, Zhi-Bo Xiao, Jin-Yun Chen, Jinyun Chen, Chen JY
International Journal of Gynecology & Obstetrics · 2025 · vol. 171(1) , pp. 438–445 · doi:10.1002/ijgo.70194 · PMID:40332033 · W4410157901
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This study found that severe pelvic adhesions are an independent risk factor for decreased pregnancy rates following high-intensity focused ultrasound ablation in adenomyosis patients.

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Abstract

OBJECTIVE: To investigate the effect of pelvic adhesions on reproductive outcomes following high-intensity focused ultrasound (HIFU) ablation in patients with adenomyosis. METHODS: A total of 396 patients with adenomyosis underwent HIFU, including 148 patients with fertility requirements. Magnetic resonance imaging (MRI) was employed to evaluate pelvic adhesions. Reproductive outcomes were evaluated subsequent to the HIFU procedure for adenomyosis, with an assessment of the effect of pelvic adhesions on reproductive outcomes. RESULTS: A total of 118 patients (79.83%), with an average age of 35.34 ± 4.66 years, were followed up for a median period of 92 months (48-122 months). Successful pregnancy was achieved in 35 individuals (29.66%), including 28 cases of natural conception and 7 cases of in vitro fertilization and embryo transfer. MRI indicated signs of pelvic adhesions in 71 patients (60.17%). Pregnant women had lower numeric rating scale (6 vs. 7, P = 0.008), uterine volume (160.74 vs. 207.57 cm3, P = 0.013), and a lower proportion of pelvic adhesions (40.00% vs. 68.67%, P = 0.004) compared with non-pregnant women. The successful pregnancy rates were 16.28%, 25.00%, and 44.68% in the severe adhesive group, mild adhesive group, and non-adhesive group, respectively. Severe pelvic adhesion was identified as an independent risk factor for achieving pregnancy following HIFU (odds ratio 0.28, 95% confidence interval 0.10-0.76, P = 0.013). CONCLUSIONS: Severe pelvic adhesion is a hindrance to achieving pregnancy following HIFU in patients with adenomyosis. Assessing pelvic adhesions is crucial for the fertility of women as it provides valuable guidance for clinical decision making.
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Abstract

Objective To investigate the effect of pelvic adhesions on reproductive outcomes following high-intensity focused ultrasound (HIFU) ablation in patients with adenomyosis.

Methods

A total of 396 patients with adenomyosis underwent HIFU, including 148 patients with fertility requirements. Magnetic resonance imaging (MRI) was employed to evaluate pelvic adhesions. Reproductive outcomes were evaluated subsequent to the HIFU procedure for adenomyosis, with an assessment of the effect of pelvic adhesions on reproductive outcomes.

Results

A total of 118 patients (79.83%), with an average age of 35.34 ± 4.66 years, were followed up for a median period of 92 months (48–122 months). Successful pregnancy was achieved in 35 individuals (29.66%), including 28 cases of natural conception and 7 cases of in vitro fertilization and embryo transfer. MRI indicated signs of pelvic adhesions in 71 patients (60.17%). Pregnant women had lower numeric rating scale (6 vs. 7, P = 0.008), uterine volume (160.74 vs. 207.57 cm3, P = 0.013), and a lower proportion of pelvic adhesions (40.00% vs. 68.67%, P = 0.004) compared with non-pregnant women. The successful pregnancy rates were 16.28%, 25.00%, and 44.68% in the severe adhesive group, mild adhesive group, and non-adhesive group, respectively. Severe pelvic adhesion was identified as an independent risk factor for achieving pregnancy following HIFU (odds ratio 0.28, 95% confidence interval 0.10–0.76, P = 0.013).

Conclusions

Severe pelvic adhesion is a hindrance to achieving pregnancy following HIFU in patients with adenomyosis. Assessing pelvic adhesions is crucial for the fertility of women as it provides valuable guidance for clinical decision making. CONFLICT OF INTEREST STATEMENT The authors have no conflicts of interest. DATA AVAILABILITY STATEMENT Owing to potential privacy concerns regarding the participants in the research, the data are not accessible to the public.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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