Abstract: Objective To compare the clinical efficacy and pregnancy outcomes of the excision of uterine adenomyoma through laparotomy and laparoscopic, and high intensity focused ultrasound(HIFU). Methods The clinical data of postoperative patients with adenomyosis who had fertility requirements were treated with those three ways in Baoding Maternal and Child Heath Hospital from October 2015 to April 2019 were analyzed retrospectively. Among them, group A was treated with laparotomy(group A)(n=50), group B was treated with laparoscopic(n=45), and group C was treated with high intensity focused ultrasound ablation(n=32). All the patients were followed up for 4 years. The operative indexes, treatment efficiency, pregnancy and outcome of each group were investigated and analyzed. Results The effective rate of group A and group B reached 100%, while that of group C was 96.88%, but there was no significant difference between treatment groups(P>0.05). Compared with groups A and B, group C had the longest operation time(P<0.05), but the intraoperative blood loss, the time to get out of bed and the number of hospital stay after operation were significantly lower than those in group A and B(P<0.05). The average hospitalization cost in group A was less than that in group B and C, but there was no significant difference between the three groups(P>0.05).The pregnancy rate was the highest in group C(59.38%), followed by group A(52.00%)and lowest in group B(48.89%), but the difference was not statistically significant(P>0.05). The spontaneous abortion rate, premature delivery rate did not differ significantly among the three groups. Compared with group A and B, group C had the shortest pregnancy interval(P<0.05). The vaginal delivery rate of group C was the highest(52.94%), which was significantly higher than that of group A and B(P<0.05). However, there was no significant difference in the average gestational age, pregnancy complications and complication rate, Apgar score and the time of menstrual resuscitation(P>0.05). Conclusion HIFU treatment of uterine fibroids and adenomyosis is effective and safe, can improve the pregnancy rate without significant adverse effects. Compared with hysteromyoma resection by laparotomy and laparoscopic, HIFU treatment has certain advantages, it is worth in-depth study and promotion.

Key words: denomyoma, pregnancy, high intensity focused ultrasound, hysteromyoma resection