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The impact of ultrasound-guided high-intensity focused ultrasound for uterine fibroid on ovarian reserve and quality of life: A prospective cohort study


      Objective: To evaluate variation of anti-Müllerian hormone (AMH) levels and quality of life in women with uterine fibroids after the treatment of ultrasound-guided high-intensity focused ultrasound (USgHIFU). Design: Prospective cohort study. Setting: International Peace Maternity and Child Health Hospital, Shanghai, China. Population: A total of 69 patients with uterine fibroids from October 2018 to November 2021. Methods: AMH levels, score of uterine fibroid symptom and quality of life (UFS-QOL) and fibroid volume before and 1-, 3-, 6-month after the USgHIFU treatment were analyzed. Correlations between AMH levels and age, fibroid types, fibroid location were assessed. Main outcome measures: Anti-Müllerian hormone levels and score of UFS-QOL. Results: Of all the 69 patients enrolled in this study, 54 patients were finally analyzed. UFS-QOL scores at baseline, 1-month and 6-month after treatment were 70 (50.75-87.50), 57(44.75-80.00), and 52(40.75-69.00), respectively ( p < 0.001). Reduction of fibroids volume rate increased significantly at 3-month compared to 1-month follow-up ( p < 0.001) and no significant change was observed between the 3-month and 6-month follow-up ( p > 0.99). The median AMH levels (ng/ml) before and at 1-, 3- and 6-month after treatment were 1.22 (0.16-3.28), 1.12 (0.18-2.52), 1.15 (0.19-2.08) and 1.18 (0.36-2.43), respectively,there was no significant difference in AMH levels among the groups ( p = 0.2), and no significant difference in subsequent subgroup analysis stratified by age ( p > 0.05). Multivariate linear regression analyses showed that women age was significantly and independently associated with AMH levels in related influencing factors. Conclusions: The short-term and long-term follow-up of USgHIFU in the treatment of Uterine fibroid shows that the treatment can significantly improve the quality of life without adverse effects on ovarian function.