title: Ovarian Reserve After Ultrasound-Guided High-Intensity Focused Ultrasound for Uterine Fibroids: Preliminary Experience.
abstract: OBJECTIVE
  To determine the effect on ovarian reserve of ultrasound-guided high-intensity focused ultrasound (HIFU) in the treatment of uterine fibroids.
  
  
  METHODS
  We performed a mid-study analysis of markers of ovarian reserve using data from a prospective cohort study evaluating the safety of ultrasound-guided HIFU for uterine fibroids. Blood samples obtained from 12 women with uterine fibroids less than one week before treatment were used for measurement of serum anti-Mullerian hormone (AMH), and this testing was repeated in the first, third, sixth, and 12th month after ultrasound-guided HIFU treatment.
  
  
  RESULTS
  Fourteen fibroids from 12 patients were treated using ultrasound-guided HIFU. The median baseline fibroid volume was 101.2 cm(3) (range 18.5 to 349.2 cm(3)). The median treatment time was 140.5 minutes (46 to 192 minutes), and median sonication time was 1449 seconds (range 541 to 2445 seconds). The median energy delivered was 575 521.5 joules (range 216 400 to 898 273 joules). The median AMH levels (ng/mL) before treatment and at one, three, six, and 12 months after treatment were 0.3 (range 0.01 to 1.94), 0.47 (0.01 to 1.43), 0.205 (0.01 to 1.81), 0.26 (0 to 2.37), and 0.06 (0.02 to 1.04), respectively. There was no significant difference between the AMH levels before and at any time after treatment. No patient became amenorrheic or reported symptoms suggestive of menopause after treatment.
  
  
  CONCLUSIONS
  Our preliminary experience suggests that ovarian reserve does not seem to be affected by ultrasound-guided HIFU in the treatment of uterine fibroids.
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
authors.forename: Vincent Y T
authors.initials: VY
authors.lastname: Cheung
authors.affiliation: Department of Diagnostic Radiology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
authors.forename: Tina P W
authors.initials: TP
authors.lastname: Lam
authors.affiliation: Department of Anaesthesiology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Jenkins
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
authors.forename: Grace K I
authors.initials: GK
authors.lastname: Cheung
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
authors.forename: Selina S Y
authors.initials: SS
authors.lastname: Chan
authors.affiliation: Department of Obstetrics and Gynaecology, Queen Mary Hospital, University of Hong Kong, Hong Kong.
authors.forename: W K
authors.initials: WK
authors.lastname: Choi
mesh_terms: D000328:Adult; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D057086:High-Intensity Focused Ultrasound Ablation / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D007889:Leiomyoma / Q000601:surgery*; D008875:Middle Aged; D065851:Ovarian Reserve; D011446:Prospective Studies; D014594:Uterine Neoplasms / Q000601:surgery*
keywords: Anti-Mullerian hormone; fibroids; high-intensity focused ultrasound