Systematic review and meta-analysis of reproductive outcomes after high-intensity focused ultrasound (HIFU) treatment of adenomyosis

IF 3.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Best Practice & Research Clinical Obstetrics & Gynaecology Pub Date : 2023-11-25 DOI:10.1016/j.bpobgyn.2023.102433

Yishan Chen , Shunhe Lin , Xi Xie , Jingsong Yi , Xishi Liu , Sun-Wei Guo

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Abstract

High-intensity focused ultrasound (HIFU) has emerged as a promising uterus-sparing and possibly fertility-sparing treatment modality for women with adenomyosis, especially those who desire to conceive. We conducted this systematic review and performed a meta-analysis on clinical studies aimed to improve reproduction in women with adenomyosis. After extensive search of PubMed and CNKI, we identified 10 studies published in English and Chinese involving a total of 557 patients with adenomyosis who desired to conceive after HIFU treatment. We found a pooled estimate of pregnancy rate of 53.4% and of the live birth rate of 35.2%, and there was a substantial heterogeneity among these studies. While there is a potential for HIFU treatment to improve fertility for patients with adenomyosis who desired to conceive, such evidence is very weak as of now. Comparative studies with much higher methodological rigor, preferably randomized clinical trials, are badly needed to further illuminate this issue.

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高强度聚焦超声(HIFU)治疗子宫腺肌病后生殖结局的系统回顾和荟萃分析

高强度聚焦超声(HIFU)已经成为一种很有前途的保留子宫和可能保留生育能力的治疗方式，特别是那些渴望怀孕的女性。我们对旨在改善子宫腺肌症患者生殖能力的临床研究进行了系统回顾和荟萃分析。在广泛检索PubMed和CNKI后，我们确定了10篇中英文发表的研究，共涉及557名希望在HIFU治疗后怀孕的子宫腺肌症患者。我们发现合并估计的妊娠率为53.4%，活产率为35.2%，这些研究之间存在很大的异质性。虽然HIFU治疗有可能提高希望怀孕的子宫腺肌症患者的生育能力，但目前这方面的证据非常薄弱。为了进一步阐明这一问题，迫切需要具有更高方法学严谨性的比较研究，最好是随机临床试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Best Practice & Research Clinical Obstetrics & Gynaecology 医学-妇产科学

CiteScore

9.40

自引率

1.80%

发文量

113

审稿时长

54 days

期刊介绍： In practical paperback format, each 200 page topic-based issue of Best Practice & Research Clinical Obstetrics & Gynaecology will provide a comprehensive review of current clinical practice and thinking within the specialties of obstetrics and gynaecology. All chapters take the form of practical, evidence-based reviews that seek to address key clinical issues of diagnosis, treatment and patient management. Each issue follows a problem-orientated approach that focuses on the key questions to be addressed, clearly defining what is known and not known. Management will be described in practical terms so that it can be applied to the individual patient.