International Journal of Hyperthermia · Available online 20 Apr 2026 · In press · DOI 10.1080/02656736.2026.2653775
Background Refractory and recurrent uterine fibroids present complex therapeutic challenges, particularly in patients who desire fertility preservation. Clinical management must balance multiple competing risks: preserving reproductive potential, preventing oestrogen-stimulated regrowth during assisted reproduction, and avoiding complications from repeated surgical interventions.Materials and methods We report a challenging case of a woman with multiple recurrent refractory uterine fibroids and associated infertility. The patient underwent two prior open myomectomies followed by four sessions of high-intensity focused ultrasonography. Due to inadequate response, subsequent combination therapy included ultrasound-guided absolute ethanol injection into the residual perfused fibroid tissue and three months of gonadotropin-releasing hormone agonist administration. Pregnancy was ultimately achieved through in vitro fertilization embryo transfer.Results Following the combined treatment approach, the patient successfully conceived and delivered a healthy newborn.Conclusion This case suggests that for patients with difficult-to-treat, recurrent uterine fibroids, a multimodal strategy combining serial high-intensity focused ultrasound procedures with adjuvant gonadotropin-releasing hormone agonist therapy may facilitate favorable reproductive outcomes. Although the evidence continues to evolve, this successful live birth offers clinical support for the use of this integrated approach in selected cases.
Abstract from DOAJ. Public domain (CC0 1.0).
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