title: Reproductive impact of MRI-guided focused ultrasound surgery for fibroids: a systematic review of the evidence.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 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.
authors.forename: Natalie A
authors.initials: NA
authors.lastname: Clark
authors.forename: Sunni L
authors.initials: SL
authors.lastname: Mumford
authors.forename: James H
authors.initials: JH
authors.lastname: Segars
mesh_terms: D000328:Adult; D019317:Evidence-Based Medicine; D005260:Female; D005298:Fertility; D006801:Humans; D007889:Leiomyoma / Q000473:pathology* / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018579:Patient Selection; D011247:Pregnancy; D011788:Quality of Life; D016896:Treatment Outcome; D014464:Ultrasonic Therapy; D014594:Uterine Neoplasms / Q000473:pathology* / Q000628:therapy
references.citation: Lancet. 2001 Jan 27;357(9252):293-8
references.pmid: 11214143
references.citation: Eur Radiol. 2012 Nov;22(11):2553-8
references.pmid: 22653287
references.citation: Eur Radiol. 2012 Feb;22(2):411-7
references.pmid: 21901565
references.citation: BJOG. 2004 Feb;111(2):95-102
references.pmid: 14723744
references.citation: J Med Imaging Radiat Oncol. 2012 Aug;56(4):409-16
references.pmid: 22883648
references.citation: Eur J Radiol. 2013 Jan;82(1):e43-9
references.pmid: 23000188
references.citation: Fertil Steril. 2010 Jun;94(1):324-30
references.pmid: 19361799
references.citation: Ultrasound Obstet Gynecol. 2009 Nov;34(5):572-8
references.pmid: 19852046
references.citation: Fertil Steril. 2006 Jan;85(1):22-9
references.pmid: 16412721
references.citation: Eur J Radiol. 2010 Nov;76(2):269-73
references.pmid: 19665856
references.citation: Fertil Steril. 2010 Jan;93(1):199-209
references.pmid: 19013566
references.citation: Reprod Sci. 2014 Apr;21(4):465-76
references.pmid: 23868442
references.citation: Fertil Steril. 2011 Jul;96(1):e9-e12
references.pmid: 21570071
references.citation: Fertil Steril. 2010 Oct;94(5):1864-8
references.pmid: 19931074
references.citation: Int J Gynaecol Obstet. 2007 Oct;99(1):56-7
references.pmid: 17599842
references.citation: Ultrasound Obstet Gynecol. 2007 Oct;30(5):771-7
references.pmid: 17899577
references.citation: J Clin Imaging Sci. 2012;2:74
references.pmid: 23393630
references.citation: Curr Opin Obstet Gynecol. 2012 Dec;24(6):368-75
references.pmid: 23014141
references.citation: Obstet Gynecol. 2006 Jul;108(1):49-54
references.pmid: 16816055
references.citation: Cardiovasc Intervent Radiol. 2014 Apr;37(2):445-50
references.pmid: 23839005
references.citation: Radiology. 2008 Oct;249(1):187-94
references.pmid: 18695211
references.citation: J Vasc Interv Radiol. 2012 Jun;23(6):786-794.e4
references.pmid: 22626269
references.citation: Semin Intervent Radiol. 2008 Dec;25(4):394-405
references.pmid: 21326581
references.citation: Hum Reprod. 2006 May;21(5):1255-9
references.pmid: 16410334
references.citation: Obstet Gynecol. 2007 Aug;110(2 Pt 1):279-87
references.pmid: 17666601
references.citation: Int J Gynaecol Obstet. 2012 Jun;117(3):273-7
references.pmid: 22465558
references.citation: AJR Am J Roentgenol. 2004 Dec;183(6):1713-9
references.pmid: 15547216
references.citation: Hum Reprod. 2012 Dec;27(12):3425-31
references.pmid: 23019304
references.citation: Eur J Obstet Gynecol Reprod Biol. 2013 Jul;169(2):304-8
references.pmid: 23523412
references.citation: BJOG. 2008 Apr;115(5):653-62
references.pmid: 18333948
references.citation: Am J Obstet Gynecol. 2007 Feb;196(2):184.e1-6
references.pmid: 17306674
references.citation: Biomed Imaging Interv J. 2010 Apr-Jun;6(2):e28
references.pmid: 21611041
references.citation: Invest Radiol. 2013 Jun;48(6):359-65
references.pmid: 23385396
references.citation: Eur Radiol. 2008 Dec;18(12):2997-3006
references.pmid: 18618119
references.citation: Cardiovasc Intervent Radiol. 2012 Oct;35(5):1205-10
references.pmid: 22146977
references.citation: Fertil Steril. 2007 Aug;88(2):497.e5-7
references.pmid: 17292361
references.citation: Mayo Clin Proc. 2006 Jul;81(7):936-42
references.pmid: 16835973
references.citation: J Vasc Interv Radiol. 2012 Dec;23(12):1589-93
references.pmid: 23099002
references.citation: BMC Res Notes. 2012 Jan 20;5:52
references.pmid: 22264277
references.citation: Acad Radiol. 2011 Aug;18(8):970-6
references.pmid: 21718955
references.citation: Yonsei Med J. 2010 May;51(3):451-3
references.pmid: 20376901
references.citation: Eur J Radiol. 2012 Nov;81(11):3652-9
references.pmid: 21959213
references.citation: J Vasc Interv Radiol. 2011 Jun;22(6):857-64
references.pmid: 21482137
references.citation: Radiology. 2007 Jun;243(3):885-93
references.pmid: 17446521
references.citation: J Obstet Gynaecol Res. 2011 Apr;37(4):370-3
references.pmid: 21392163
references.citation: J Perinatol. 2007 Jan;27(1):59-61
references.pmid: 17180132
references.citation: Eur J Obstet Gynecol Reprod Biol. 2009 Apr;143(2):98-102
references.pmid: 19185968
references.citation: Radiology. 1993 Dec;189(3):721-5
references.pmid: 8234695
references.citation: Health Qual Life Outcomes. 2008 Nov 12;6:99
references.pmid: 19014505