EP26.05: Prevalence of adenomyosis, as diagnosed at transvaginal ultrasound, in infertile women scheduled for their first assisted reproductive treatment

To determine the prevalence of direct and indirect features of adenomyosis, as defined by the revised Morphological Uterus Sonographic Assessment (MUSA) group, in infertile women. Infertile women aged 25–39 years, scheduled for their first assisted reproductive treatment (ART), underwent a transvaginal 2D and 3D ultrasound examination (TVUS) of the uterus between December 2018 and May 2021. All ultrasound examinations were performed by an examiner with experience in adenomyosis, using GE Voluson 10 Expert ultrasound equipment (GE Medical Systems, Zipf, Austria) with a 5-9 MHz transvaginal transducer. Direct and indirect features of adenomyosis were described at 2D or 3D TVUS according to the revised MUSA definitions. Direct adenomyosis features visible only at 2D TVUS or only in the coronal view of the uterus at 3D TVUS was reported as well. Out of 1191 women included, 282 (23.7%, 95% CI (21.3 – 26.1)) women had any feature of adenomyosis. Direct features were detected in 117 (9.8%; 95% CI (8.1 – 11.5)) women. Out of these, direct features were seen at 2D TVUS only in 7 (0.6%) women and at 3D TVUS only in 58 (4.9%) women. The study showed that almost one quarter of women referred for their first ART had direct and/or indirect features of adenomyosis. The use of 3D TVUS is an important complement to 2D TVUS in detecting direct features of adenomyosis. Studies are needed to establish the impact of different ultrasound features of adenomyosis on ART results.