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Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence

Clark, Natalie A.a; Mumford, Sunni L.b; Segars, James H.c

Current Opinion in Obstetrics and Gynecology: June 2014 - Volume 26 - Issue 3 - p 151–161
doi: 10.1097/GCO.0000000000000070
FERTILITY: Edited by Aydin Arici

Purpose of review Magnetic-resonance-guided focused ultrasound surgery (MRgFUS) is a minimally invasive technique for the treatment of uterine fibroids. The purpose of this review is to highlight the impact of MRgFUS on fertility and reproductive outcomes.

Recent findings The role of MRgFUS in the treatment of fibroids has been evolving since its introduction in 2004. Several new devices and techniques including location-specific treatment, volumetric therapy, and vessel-targeted therapy have been introduced over the last few years. Several case series report uncomplicated pregnancy following MRgFUS; however, results of the ongoing studies will further elucidate the utility of MRgFUS in patients planning future fertility. A systematic review of the literature was completed and studies that reported quality of life at baseline and after 6 months were included in a meta-analysis.

Summary MRgFUS represents a minimally invasive treatment for uterine fibroids that is able to improve the quality of life and fibroid size with durability. It is possible that MRgFUS could be the treatment of choice for patients desiring future fertility; however, further investigation is needed.

aDepartment of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan

bEpidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development

cProgram in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA

Correspondence to James H. Segars, MD, Building 10, CRC, Room 1E-3140, 10 Center Drive, Bethesda, MD 20892, USA. Tel: +1 301 496 5800; fax: +1 301 402 0884; e-mail: segarsj@mail.nih.gov

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins