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Review
. 2023 Aug 26;59(9):1551.
doi: 10.3390/medicina59091551.

Adenomyosis and Infertility: A Literature Review

Affiliations
Review

Adenomyosis and Infertility: A Literature Review

George Pados et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Adenomyosis (the presence of ectopic endometrial glands and stroma below the endometrial-myometrial junction) is a benign condition which is increasingly diagnosed in younger women suffering from infertility. The aim of this narrative review was to study the pathophysiology and prevalence of adenomyosis, the mechanisms causing infertility, treatment options, and reproductive outcomes in infertile women suffering from adenomyosis. Materials and Methods: A literature search for suitable articles published in the English language was performed using PubMed from January 1970 to July 2022. Results: The literature search retrieved 50 articles that met the purpose of this review and summarized the most recent findings regarding the accuracy of diagnostic methods, pathophysiology, and the prevalence of adenomyosis and optimal strategies for the treatment of infertile women with adenomyosis. Conclusions: Adenomyosis is a common gynecological disorder, affecting women of reproductive age. It negatively affects in vitro fertilization, pregnancy and the live birth rate, as well as increases the risk of miscarriage. With the advent of non-invasive diagnoses with MRI and TVUS, the role of adenomyosis in infertility has been better recognized. Overall, more randomized controlled trials (RCTs) are needed to provide strong data on the accuracy of diagnostic methods, the pathophysiology and the prevalence of adenomyosis, the fertility outcomes of patients and the optimal strategy for the treatment.

Keywords: adenomyosis; classification; diagnosis; infertility; pathogenesis; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study selection process.
Figure 2
Figure 2
Negative impact of adenomyosis on the individual steps of reproduction.

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References

    1. Aleksandrovych V., Basta P., Gil K. Current facts constituting an understanding of the nature of adenomyosis. Adv. Clin. Exp. Med. 2019;28:839–846. doi: 10.17219/acem/79176. - DOI - PubMed
    1. Martone S., Centini G., Exacoustos C., Zupi E., Afors K., Zullo F., Maneschi F., Habib N., Lazzeri L. Pathophysiologic mechanisms by which adenomyosis predisposes to postpartum haemorage and other obstetric complications. Med. Hypotheses. 2020;143:109833. doi: 10.1016/j.mehy.2020.109833. - DOI - PubMed
    1. Ferenczy A. Pathophysiology of adenomyosis. Hum. Reprod. Updat. 1998;4:312–322. doi: 10.1093/humupd/4.4.312. - DOI - PubMed
    1. Zou Y., Liu F.-Y., Wang L.-Q., Guo J.-B., Yang B.-C., Wan X.-D., Wang F., He M., Huang O.-P. Downregulation of DNA methyltransferase 3 alpha promotes cell proliferation and invasion of ectopic endometrial stromal cells in adenomyosis. Gene. 2017;604:41–47. doi: 10.1016/j.gene.2016.12.011. - DOI - PubMed
    1. Enatsu A., Harada T., Yoshida S., Iwabe T., Terakawa N. Adenomyosis in a patient with the Rokitansky-Kuster-Hauser syndrome. Fertil. Steril. 2000;73:862–863. doi: 10.1016/S0015-0282(99)00643-3. - DOI - PubMed