The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

doi:10.3390/jcm13092531

Review

. 2024 Apr 25;13(9):2531.

doi: 10.3390/jcm13092531.

The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

Gaby Moawad^{1

2}, Youssef Youssef³, Arrigo Fruscalzo⁴, Hani Faysal⁵, Manuel Merida⁶, Paul Pirtea⁷, Benedetta Guani⁴, Jean Marc Ayoubi⁷, Anis Feki⁴

Affiliations

¹ Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC 20037, USA.
² The Center for Endometriosis and Advanced Pelvic Surgery, Washington, DC 22101, USA.
³ Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
⁴ Department of Obstetrics and Gynecology, HFR-Hòpital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.
⁵ Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN 46204, USA.
⁶ Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University, Flint, MI 48503, USA.
⁷ Department of Obstetrics and Gynecology and Reproductive Medicine, Faculté de Médecine Paris, Hopital Foch, 92150 Suresnes, France.

PMID: 38731060
PMCID: PMC11084146
DOI: 10.3390/jcm13092531

Review

The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

Gaby Moawad et al. J Clin Med. 2024.

. 2024 Apr 25;13(9):2531.

doi: 10.3390/jcm13092531.

Authors

Gaby Moawad^{1

2}, Youssef Youssef³, Arrigo Fruscalzo⁴, Hani Faysal⁵, Manuel Merida⁶, Paul Pirtea⁷, Benedetta Guani⁴, Jean Marc Ayoubi⁷, Anis Feki⁴

Affiliations

¹ Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC 20037, USA.
² The Center for Endometriosis and Advanced Pelvic Surgery, Washington, DC 22101, USA.
³ Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY 11219, USA.
⁴ Department of Obstetrics and Gynecology, HFR-Hòpital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.
⁵ Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN 46204, USA.
⁶ Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University, Flint, MI 48503, USA.
⁷ Department of Obstetrics and Gynecology and Reproductive Medicine, Faculté de Médecine Paris, Hopital Foch, 92150 Suresnes, France.

PMID: 38731060
PMCID: PMC11084146
DOI: 10.3390/jcm13092531

Abstract

Adenomyosis is a benign condition commonly encountered in patients with infertility. While the definitive surgical management is hysterectomy, conservative surgical management is gaining attention in patients desiring future fertility. This review explores whether the surgical treatment of adenomyosis affects fertility outcomes for patients trying to conceive. The PubMed and Medline databases were searched using the keywords: "adenomyosis", "surgery", "radiofrequency", "infertility", "pregnancy", "sterility", "conception", "miscarriage", and "endometrial receptivity". Abstracts were screened, and relevant articles were selected for review. This review reveals that surgery appears to improve fertility outcomes with or without medical therapy; however, the risk of uterine rupture remains high and the best technique to reduce this risk is still not known. More studies are needed to formulate the best surgical approach for preserving fertility in treating adenomyosis and to establish standardized guidelines.

Keywords: adenomyosis; fertility outcomes; infertility; pregnancy; surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Cited by

Advances in Adenomyosis Treatment: High-Intensity Focused Ultrasound, Percutaneous Microwave Therapy, and Radiofrequency Ablation.
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Robotic-assisted excision of diffuse adenomyosis.
Youssef Y, Alkatout I, Ayoubi JM, Feki A, Moawad G. Youssef Y, et al. Facts Views Vis Obgyn. 2024 Sep;16(3):365-368. doi: 10.52054/FVVO.16.3.034. Facts Views Vis Obgyn. 2024. PMID: 39357869 Free PMC article.
Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis.
Moawad G, Youssef Y, Fruscalzo A, Khedhri S, Faysal H, Pirtea P, Guani B, Vallée A, Ayoubi JM, Feki A. Moawad G, et al. Front Reprod Health. 2024 Dec 9;6:1484202. doi: 10.3389/frph.2024.1484202. eCollection 2024. Front Reprod Health. 2024. PMID: 39717429 Free PMC article. Review.
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References

1. Mishra I., Melo P., Easter C., Sephton V., Dhillon-Smith R., Coomarasamy A. Prevalence of adenomyosis in women with subfertility: Systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2023;62:23–41. doi: 10.1002/uog.26159. - DOI - PubMed
1. Upson K., Missmer S.A. Epidemiology of Adenomyosis. Semin. Reprod. Med. 2020;38:89–107. doi: 10.1055/s-0040-1718920. - DOI - PMC - PubMed
1. Deblaere L., Froyman W., Bosch T.V.D., Van Rompuy A., Kaijser J., Deprest J., Timmerman D. Juvenile cystic adenomyosis: A case report and review of the literature. Australas. J. Ultrasound Med. 2019;22:295–300. doi: 10.1002/ajum.12171. - DOI - PMC - PubMed
1. Exacoustos C., Lazzeri L., Martire F.G., Russo C., Martone S., Centini G., Piccione E., Zupi E. Ultrasound Findings of Adenomyosis in Adolescents: Type and Grade of the Disease. J. Minim. Invasive Gynecol. 2021;29:291–299.e1. doi: 10.1016/j.jmig.2021.08.023. - DOI - PubMed
1. Taran F.A., Stewart E.A., Brucker S. Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. Geburtshilfe Und Frauenheilkd. 2013;73:924–931. doi: 10.1055/s-0033-1350840. - DOI - PMC - PubMed

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[1] Mishra I., Melo P., Easter C., Sephton V., Dhillon-Smith R., Coomarasamy A. Prevalence of adenomyosis in women with subfertility: Systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2023;62:23–41. doi: 10.1002/uog.26159. - DOI - PubMed

[2] Mishra I., Melo P., Easter C., Sephton V., Dhillon-Smith R., Coomarasamy A. Prevalence of adenomyosis in women with subfertility: Systematic review and meta-analysis. Ultrasound Obstet. Gynecol. 2023;62:23–41. doi: 10.1002/uog.26159. - DOI - PubMed

[3] Upson K., Missmer S.A. Epidemiology of Adenomyosis. Semin. Reprod. Med. 2020;38:89–107. doi: 10.1055/s-0040-1718920. - DOI - PMC - PubMed

[4] Upson K., Missmer S.A. Epidemiology of Adenomyosis. Semin. Reprod. Med. 2020;38:89–107. doi: 10.1055/s-0040-1718920. - DOI - PMC - PubMed

[5] Deblaere L., Froyman W., Bosch T.V.D., Van Rompuy A., Kaijser J., Deprest J., Timmerman D. Juvenile cystic adenomyosis: A case report and review of the literature. Australas. J. Ultrasound Med. 2019;22:295–300. doi: 10.1002/ajum.12171. - DOI - PMC - PubMed

[6] Deblaere L., Froyman W., Bosch T.V.D., Van Rompuy A., Kaijser J., Deprest J., Timmerman D. Juvenile cystic adenomyosis: A case report and review of the literature. Australas. J. Ultrasound Med. 2019;22:295–300. doi: 10.1002/ajum.12171. - DOI - PMC - PubMed

[7] Exacoustos C., Lazzeri L., Martire F.G., Russo C., Martone S., Centini G., Piccione E., Zupi E. Ultrasound Findings of Adenomyosis in Adolescents: Type and Grade of the Disease. J. Minim. Invasive Gynecol. 2021;29:291–299.e1. doi: 10.1016/j.jmig.2021.08.023. - DOI - PubMed

[8] Exacoustos C., Lazzeri L., Martire F.G., Russo C., Martone S., Centini G., Piccione E., Zupi E. Ultrasound Findings of Adenomyosis in Adolescents: Type and Grade of the Disease. J. Minim. Invasive Gynecol. 2021;29:291–299.e1. doi: 10.1016/j.jmig.2021.08.023. - DOI - PubMed

[9] Taran F.A., Stewart E.A., Brucker S. Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. Geburtshilfe Und Frauenheilkd. 2013;73:924–931. doi: 10.1055/s-0033-1350840. - DOI - PMC - PubMed

[10] Taran F.A., Stewart E.A., Brucker S. Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. Geburtshilfe Und Frauenheilkd. 2013;73:924–931. doi: 10.1055/s-0033-1350840. - DOI - PMC - PubMed

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The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

Affiliations

The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

Authors

Affiliations

Abstract

Conflict of interest statement

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Cited by

References

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Abstract

Conflict of interest statement

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References

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