{"paper_id":"89032a30-956f-45d5-8b22-277e4c31e42b","body_text":"Abstract\nAdenomyosis was thought to be present only in parous women. However, with the routine use of transvaginal ultrasound in infertility practice, the burden of adenomyosis in the infertile population has become more evident. The prevalence of adenomyosis was found to be 24.4% and 22% in women aged ≥40 years and ≤40 years in patients prior to reproductive treatment, respectively. This was found to be higher in women with recurrent pregnancy loss (38.2%) and previous ART failure (34.7%) when compared with the rest. Various mechanisms causing infertility are proposed by different authors, and any or a combination of many of these can lead to this dreadful condition. The treatment options for such cases depend on the woman’s age, reproductive status, and clinical symptoms. Many different medical and surgical methods are being offered, but there is still no drug specific for adenomyosis. Many medications are used off-label to manage pain and bleeding and sometimes even improve fertility outcome. The most commonly used and studied drug is GnRH agonist, but as it has negative effects in IVF cycles, it can be used after ovarian stimulation and before a frozen embryo transfer. Surgery for adenomyosis is less popular but yet a valid option. There is no conclusive evidence of a “best” method, and proper randomized studies targeting impact on fertility are lacking.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nChange history\n10 September 2022\nCorrection to:\nReferences\nBird CC, McElin TW, Manalo-Estrella P. The elusive adenomyosis of the uterus-revisited. Am J Obstet Gynecol. 1972;112:583–93.\nPuente JM, Fabris A, Patel J, Patel A, Cerrillo M, Requena A, et al. Adenomyosis in infertile women: prevalence and the role of 3D ultrasound as a marker of severity of the disease. Reprod Biol Endocrinol. 2016;14:60.\nNaftalin J, Hoo W, Pateman K, Mavrelos D, Holland T, Jurkovic D. How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic. Hum Reprod. 2012;27:3432–9.\nMarcellin L, Santulli P, Bourdon M, Maignien C, Campin L, Lafay-Pillet MC, et al. Focal adenomyosis of the outer myometrium and deep infiltrating endometriosis severity. Fertil Steril. 2020;114:818–27.\nBenagiano G, Brosens I. History of adenomyosis. In: Best practice and research: clinical obstetrics and gynaecology, vol. 20. Baillière Tindall; 2006. p. 449–63.\nBarrier BF, Malinowski MJ, Dick EJ, Hubbard GB, Bates GW. Adenomyosis in the baboon is associated with primary infertility. Fertil Steril. 2004;82:1091–4.\nLyons EA, Taylor PJ, Zheng XH, Ballard G, Levi CS, Kredentser J, v. Characterization of subendometrial myometrial contractions throughout the menstrual cycle in normal fertile women. Fertil Steril. 1991;55:771–4.\nKunz B, Beil D, Huppert P, Leyendecker G. Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging. Hum Reprod. 2000;15:76–82.\nKitawaki J, Noguchi T, Amatsu T, Maeda K, Tsukamoto K, Yamamoto T, et al. Expression of aromatase cytochrome P450 protein and messenger ribonucleic acid in human endometriotic and adenomyotic tissues but not in normal endometrium. Biol Reprod. 1997;57:514–9.\nBrosens J, Verhoeven H, Campo R, Gianaroli L, Gordts S, Hazekamp J, et al. High endometrial aromatase P450 mRNA expression is associated with poor IVF outcome. Hum Reprod. 2004;19:352–6.\nXiao Y, Sun X, Yang X, Zhang J, Xue Q, Cai B, et al. Leukemia inhibitory factor is dysregulated in the endometrium and uterine flushing fluid of patients with adenomyosis during implantation window. Fertil Steril. 2010;94:85–9.\nWang J, Huang C, Jiang R, Du Y, Zhou J, Jiang Y, Yan Q, Xing J, Hou X, Zhou J, Sun H. Decreased endometrial IL-10 impairs endometrial receptivity by downregulating HOXA10 expression in women with adenomyosis. Biomed Res Int. 2018;2018\nMartínez-Conejero JA, Morgan M, Montesinos M, Fortuño S, Meseguer M, Simón C, et al. Adenomyosis does not affect implantation, but is associated with miscarriage in patients undergoing oocyte donation. Fertil Steril. 2011;96:943–950.e1.\nYounes G, Tulandi T. Effects of adenomyosis on in vitro fertilization treatment outcomes: a meta-analysis. Fertil Steril. 2017;108:483–490.e3.\nVercellini P, Consonni D, Dridi D, Bracco B, Frattaruolo MP, Somigliana E. Uterine adenomyosis and in vitro fertilization outcome: a systematic review and meta-analysis. Hum Reprod. 2014;29:964–77.\nNirgianakis K, Kalaitzopoulos DR, Schwartz AS, Spaanderman M, Kramer BW, Mueller MD, Mueller M. Fertility, pregnancy and neonatal outcomes of patients with adenomyosis: a systematic review and meta-analysis. Reprod Biomed Online. 2020;42:185–206.\nBourdon M, Santulli P, Oliveira J, Marcellin L, Maignien C, Melka L, et al. Focal adenomyosis is associated with primary infertility. Fertil Steril. 2020;114:1271–7.\nHou X, Xing J, Shan H, Mei J, Sun Y, Yan G, et al. The effect of adenomyosis on IVF after long or ultra-long GnRH agonist treatment. Reprod Biomed Online. 2020;41:845–53.\nChen M, Luo L, Wang Q, Gao J, Chen Y, Zhang Y, et al. Impact of gonadotropin-releasing hormone agonist pre-treatment on the cumulative live birth rate in infertile women with Adenomyosis treated with IVF/ICSI: a retrospective cohort study. Front Endocrinol. 2020;11:318.\nNiu Z, Chen Q, Sun Y, Feng Y. Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis. Gynecol Endocrinol. 2013;29:1026–30.\nLi X, Pan N, Zhang W, Wang Y, Ge Y, Wei H, et al. Association between uterine volume and pregnancy outcomes in adenomyosis patients undergoing frozen-thawed embryo transfer. Reprod Biomed Online. 2021;42:384–9.\nBadawy AM, Elnashar AM, Mosbah AA. Aromatase inhibitors or gonadotropin-releasing hormone agonists for the management of uterine adenomyosis: a randomized controlled trial. Acta Obstet Gynecol Scand. 2012;91:489–95.\nZhang L, Rao F, Setzen R. High intensity focused ultrasound for the treatment of adenomyosis: selection criteria, efficacy, safety and fertility. Acta Obstet Gynecol Scand. 2017;96:707–14.\nAlonso Pacheco L, Laganà AS, Garzon S, Pérez Garrido A, Flores Gornés A, Ghezzi F. Hysteroscopic outpatient metroplasty for T-shaped uterus in women with reproductive failure: results from a large prospective cohort study. Eur J Obstet Gynecol Reprod Biol. 2019;243:173–8.\nMikos T, Lioupis M, Anthoulakis C, Grimbizis GF. The outcome of fertility-sparing and nonfertility-sparing surgery for the treatment of adenomyosis. A Systematic Review and Meta-analysis. J Minim Invasive Gynecol. 2020;27:309–31.\nAuthor information\nAuthors and Affiliations\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG\nAbout this chapter\nCite this chapter\nBanker, J., Banker, M., Garcia-Velasco, J.A. (2022). Adenomyosis in Reproductive Years: Fertility and ART in Adenomyosis. In: Oral, E. (eds) Endometriosis and Adenomyosis. Springer, Cham. https://doi.org/10.1007/978-3-030-97236-3_37\nDownload citation\nDOI: https://doi.org/10.1007/978-3-030-97236-3_37\nPublished:\nPublisher Name: Springer, Cham\nPrint ISBN: 978-3-030-97235-6\nOnline ISBN: 978-3-030-97236-3\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}