The effect of ultrasound-guided high-intensity focused ultrasound treatment for cesarean scar pregnancy on ovarian reserve

Abstract

Objective

The aim of this study was to evaluate changes in anti-Müllerian hormone (AMH) levels after ultrasound-guided high-intensity focused ultrasound (USgHIFU) treatment of cesarean scar pregnancy (CSP).

Methods

A retrospective case series study was conducted in the Affiliated Hospital of North Sichuan Medical College. Thirty-two women with cesarean scar pregnancy who met the inclusion criteria were enrolled in the study between January 2018 and December 2019. All patients underwent USgHIFU treatment with or without suction curettage. Intraoperative blood loss in suction curettage and hysteroscopy procedures, time to return of β-human chorionic gonadotropin (β-hCG) to normal levels, and time to recovery of normal menstruation were recorded. AMH levels before and 3 months after HIFU treatment were compared to determine whether USgHIFU treatment affected ovarian reserve.

Results

AMH levels before and 3 months after HIFU ablation were 1.87 ± 1.19 ng/ml and 1.90 ± 1.17 ng/ml, respectively. There was no significant difference in AMH levels between the two-time points (p > .05). The median volume of intraoperative blood loss was 20 ml, the median time for the serum β-hCG level to return to normal was 35.5 days, and the median time of menstruation recovery was 39 days.

Conclusions

USgHIFU treatment for CSP was effective and safe without affecting ovarian reserve.

Keywords:

• CSP
• anti-Müllerian hormone
• HIFU
• ovarian reserve

Acknowledgments

We are grateful to the patients who participated in this study and acknowledge the contribution of clinical staff from the Affiliated Hospital of North Sichuan Medical College for the treatment of patients and the delivery of clinical care.

Author Contributions

Wenping Wang: data acquisition; analysis and interpretation; drafting the article and final approval of the version to be published. Jing Jiang, Yan Chen: performance of USgHIFU ablation of the patients. Chengzhi Li: data analysis and interpretation. Honggui Zhou, Zhibiao Wang: responsible for the initial concept, data acquisition and final review of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by Nanchong City School Science and Technology Strategic Cooperation Project (No: 19SXHZ0145).