Changes in Tissue Endometrial Receptivity under the Influence of High Intensity Focused Ultrasound during Ablation of Uterine Fibroids in Patients of Reproductive Age

Objective: To investigate the influence of the MRI-guided high-intensity focused ultrasound ablation (HIFU) of uterine fibroids on the endometrial receptivity in patients planning pregnancy. Material and Methods: A prospective comparative controlled study of 95 reproductive age women planning a pregnancy with symptomatic uterine fibroids was conducted. 32 patients receiving HIFU treatment and 35 women receiving surgical treatment under laparoscopic myomectomy were examined. A control group was existing 28 healthy fertile women, examined voluntarily. The endometrium obtained with pipelle biopsia on days 20-22 of the menstrual cycle was examined by immunohistochemistry before and three months after the treatment. Statistical analysis of the results was carried out using SPSS 22.0. Results: It was established that the focusing ultrasound rays passing through the endometrium do not cause changes in the maturation rate and do not affect the state of intercellular contacts. At the same time, a significant increase in the frequency of asynchronous maturation of pinopodia was found to be 50.00% (16) versus 14.28% (4); p=0.021 and the number of heteromorphic secretory cells 53.33% (8) versus 5.88% (1); p=0.002 in implantation endometrium. Conclusions: The study did not reveal any significant negative effects of focused ultrasonic waves during FUSMRI ablation of uterine fibroids on endometrial receptivity in women of reproductive age. MRg HIFU ablation of uterine fibroids might be considered as an alternative treatment in patients of reproductive age with uterine fibroids planning a pregnancy. Content: A prospective comparative controlled study of 95 women planning a pregnancy with symptomatic uterine fibroids, who received treatment by HIFU ablation and laparoscopic myomectomy.