Successful Pregnancies in Women Seeking Fertility Enhancement with MRI Guided Focused Ultrasound (MRgFUS) Fibroid Ablation — YRD
  1. Schedule
  2. Session 3 - Free Communications : Chairman's Choice
  3. Successful Pregnancies in Women Seeking Fertility Enhancement with MRI Guided Focused Ultrasound (MRgFUS) Fibroid Ablation

Successful Pregnancies in Women Seeking Fertility Enhancement with MRI Guided Focused Ultrasound (MRgFUS) Fibroid Ablation (2447)

Karen Kong 1 , Emma Pun 2 , Amber Moore 3 , Lynn Burmeister 4 , Mark Petris 5 , Gareth Weston 4 , Catarina Ang 1 , Andrew Dobrotwir 2
  1. Department of Gynaecology 1 unit, The Royal Women's Hospital, Parkville, VIC, Australia
  2. Department of Radiology, The Royal Women's Hospital, Parkville, VIC, Australia
  3. St Vincent's Private Hospital Melbourne, Fitzroy, VIC, Australia
  4. Monash IVF, Melbourne, VIC, Australia
  5. Monash Medical Centre, Clayton, VIC, Australia

Background:

The role of fibroids in infertility and the role of fibroid treatment to enhance fertility continue to be controversial and contentious issues. Females in developed countries tend to start a family at an age when natural fertility is in decline and the incidence of fibroids is increasing, this issue is becoming more relevant. Recent publications have attempted to analyze the available data and draw conclusions regarding the significance of fibroids with respect to fertility and pregnancy outcomes. Consensus panels have proposed treatment recommendations for symptomatic fibroids where the patient desires fertility preservation and also for fertility enhancement in the context of fibroid related infertility or failed assisted reproductive techniques (1).

MRI guided focused Ultrasound (MRgFUS) have become established in the treatment of symptomatic fibroids, clinicians have expressed concern, initially regarding the safety in future pregnancy and subsequently the efficacy of these treatment modalities in infertility.

As promising data has emerged over time with respect to MRgFUS, favourable pregnancy outcomes and even a role in fertility enhancement, a major limitation has been the lack of published data and limited patient numbers (2,3). We aim to add to this growing body of literature with this report, which is the first to incorporate 16 consecutive successful live births in 14 women following fibroid MRgFUS specifically for fertility enhancement in the setting of primary infertility, secondary infertility, and in increasing the success rates of assisted reproductive techniques.

Objective: To describe a series of 16 consecutive live births in women seeking fertility enhancement with MRI guided focused ultrasound uterine fibroid ablation.

Design: Retrospective report

Setting: University hospital and Private Centre for MRI guided focused ultrasound treatment.

Patients: Women with uterine fibroids and primary or secondary infertility seeking fertility enhancement with MRgFUS.

Interventions: MRI guided focused ultrasound ablation of uterine fibroids to enhance fertility in patients with primary or secondary infertility.

Main outcome measures: Time from treatment to conception, method of conception, intrapartum complications and Obstetric outcomes including gestational age at delivery, mode of delivery, birth weight, Apgar scores and post-partum complications.

Results: 16 healthy babies were born to 14 women following MRI guided focused ultrasound fibroid ablation to enhance fertility in the setting of primary or secondary infertility.

Conclusions: Women suffering primary or secondary infertility with uterine fibroids seeking fertility enhancement may conceive spontaneously or with assisted reproductive techniques following MRI guided focused ultrasound fibroid ablation, resulting in successful term pregnancies

  1. Kroon B, Johnson N, Chapman M, Yazdani A, Hart R . Fibroids in infertility--consensus statement from accept (australasian crei consensus expert panel on trial evidence). Aust N Z J Obstet Gynaecol 2011; 51: 289-295.
  2. Bouwsma EVA, Gorny KR, Hesley GK, Jensen JR, Peterson LG Stewart EA . Magnetic resonance-guided focused ultrasound surgery for leiomyoma-associated infertility. Fertil Steril 2011; 96: e9-e12.
  3. Zaher S, Lyons D Regan L . Successful in vitro fertilization pregnancy following magnetic resonance-guided focused ultrasound surgery for uterine fibroids. J Obstet Gynaecol Res 2011; 37: 370-373.