MAGNETIC RESONANCE-GUIDED FOCUSED ULTRASOUND IN GYNECOLOGY: FUNDAMENTALS AND SAFETY, POTENTIAL IMPACT ON FERTILITY AND PREGNANCY OUTCOMES. LITERATURE REVIEW
Background and Objective. Uterine fibroids are the most common benign tumor in women of reproductive age (20-40%). Given the trend toward delayed childbearing and the high frequency of hysterectomies, organ-preserving, minimally invasive methods such as Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) ablation are becoming highly relevant. The objective of this review is to study and systematize publications on the use of MRgFUS technology, focusing on its impact on fertility and reproductive outcomes.
Methods. A comprehensive and systematic search of scientific literature from the last 10-20 years was conducted in databases (PubMed, Medline, Google Scholar, etc.) using keywords including “MRgFUS,” “uterine fibroids,” “fertility,” and “HIFU.” Out of 1247 identified studies, 46 of the most relevant publications meeting strict criteria were included in the final review.
Results. MRgFUS ablation is a safe and effective method based on the thermal coagulative necrosis of myoma tissue. Efficacy depends on the histological structure of the fibroid (hypointense on T2WI is preferred) and careful patient selection. Live birth rates after MRgFUS are encouraging, ranging from 41% to over 70%. The miscarriage rate (8-28%) is comparable to that following other conservative interventions and is lower than after Uterine Artery Embolization. MRgFUS preserves uterine integrity and does not increase the risk of uterine rupture or placental abnormalities. However, the reintervention rate may be higher than after myomectomy.
Conclusions. MRgFUS is a promising, minimally invasive option for fertility preservation in women with uterine fibroids. Reproductive outcomes are comparable to other conservative methods. Treatment success critically depends on strict patient selection and technical aspects. Large prospective randomized studies are necessary to clarify long-term reproductive outcomes and optimize protocols, especially in combination with Assisted Reproductive Technology.
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Meirmanova M.М., Abiltayeva A.A., Abiltayev A.M., Myssaev A.О., Myssayeva G.M., Kairkhanov Ye.K., Kazangapov R.S., Siyazbekova Z.S. Magnetic resonance-guided focused ultrasound in gynecology: fundamentals and safety, potential impact on fertility and pregnancy outcomes. Literature review // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (6), pp. 185-192. doi 10.34689/SH.2025.27.6.020Related publications:
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MAGNETIC RESONANCE-GUIDED FOCUSED ULTRASOUND IN GYNECOLOGY: FUNDAMENTALS AND SAFETY, POTENTIAL IMPACT ON FERTILITY AND PREGNANCY OUTCOMES. LITERATURE REVIEW