Ultrasound-guided radiofrequency ablation of an intramural fibroid in a woman desiring fertility with coexisting focal adenomyosis: a case report

AJOG global reports Pub Date : 2026-05-01 Epub Date: 2026-04-09 DOI:10.1016/j.xagr.2026.100645

Francesco G. Martire MD, PhD, Claudia d’Abate MD, Eugenia Costantini MD, Ilaria Ianes MD, Emilio Pieri MD, Lorenza Minisci MD, Maria De Bonis MD, Lucia Lazzeri MD, PhD, Errico Zupi MD

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Abstract

Objective

To report the reproductive outcome after ultrasound-guided radiofrequency ablation (RFA) in a woman with an intramural uterine fibroid and coexisting focal adenomyosis who experienced infertility and desired pregnancy.

Design

Case report.

Patient

A 40-year-old nulligravid woman with heavy menstrual bleeding, dysmenorrhea, and a history of infertility, defined by failure to conceive after more than 12 months of unprotected intercourse. Transvaginal ultrasound demonstrated a FIGO type 3 intramural fibroid distorting the endometrial cavity and associated focal anterior adenomyosis.

Intervention

Ultrasound-guided transvaginal RFA of the intramural fibroid.

Main Outcome Measures

Changes in fibroid volume and uterine cavity morphology on ultrasound, improvement of clinical symptoms, and reproductive outcome.

Results

The procedure was completed without complications. Follow-up ultrasound showed progressive fibroid volume reduction of 76.9% at 6 months, migration of the lesion away from the endometrial cavity, restoration of normal cavity anatomy, and improvement of sonographic features of focal adenomyosis. Menstrual symptoms improved significantly. Spontaneous conception subsequently occurred, resulting in an uncomplicated term vaginal delivery.

Conclusion

This case suggests that ultrasound-guided RFA may represent a minimally invasive, uterus-sparing option for selected women with intramural fibroids and coexisting focal adenomyosis associated with infertility.

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超声引导下射频消融术治疗伴有局灶性bbb的女性子宫肌瘤一例

目的探讨超声引导下子宫肌瘤合并局灶性子宫腺肌症合并不孕的妇女行射频消融术后的生殖结果。DesignCase报告。患者：40岁无孕女性，月经大出血，痛经，有不孕症史，无保护性交超过12个月后仍未怀孕。经阴道超声显示FIGO 3型膜内肌瘤扭曲子宫内膜腔和相关的局灶性前bbb。超声引导下经阴道壁内肌瘤射频消融术。主要观察指标：超声检查肌瘤体积和子宫腔形态的改变、临床症状的改善和生殖结局。结果手术完成，无并发症。随访超声显示，6个月时肌瘤体积进行性缩小76.9%，病变远离子宫内膜腔，腔内解剖恢复正常，局灶性子宫腺肌症超声特征改善。月经症状明显改善。随后发生了自然受孕，导致了一个简单的阴道分娩。结论该病例提示超声引导下的射频消融术可能是一种微创、保留子宫的选择，适用于有子宫肌瘤和局灶性bbb合并不孕症的患者。

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

AJOG global reports Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Perinatology, Pediatrics and Child Health, Urology

CiteScore

1.20

自引率

0.00%

发文量