Live birth after conservative surgery for severe adenomyosis following magnetic resonance imaging and gonadotropin-releasing hormone agonist therapy.
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A woman with severe adenomyosis and secondary infertility conceived and delivered a live infant via cesarean section following MRI diagnosis, GnRH-a therapy, and conservative surgical resection of a localized myometrial mass.
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Abstract
This is a report of a live birth after conservative surgery for severe adenomyosis following diagnosis by MRI and therapy with GnRH-a. A 33-year-old gravida 1 para 1 woman with a 5-year history of secondary infertility received a gonadotropin-releasing hormone agonist (GnRH-a), leuprolide acetate, for 16 weeks to control symptoms of severe adenomyosis and to treat infertility. However, severe dysmenorrhea recurred after the discontinuation of therapy. Because an elevated serum level of CA-125 and MRI findings suggested that she was experiencing a relapse of adenomyosis, GnRH-a therapy was re-instituted. After 24 weeks of the second therapy, her uterus decreased to normal size and an MRI revealed a localized low-signal-intensity myometrial mass with well-defined borders. We easily resected the localized lesion of adenomyosis using the same technique used to treat uterine leiomyoma. The patient became pregnant after 12 weeks of additional danazol therapy. A healthy male infant was delivered at term by cesarean section.
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Cited by (30)
- Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis 2023
- Faculty Opinions recommendation of The impact of adenomyosis on women's fertility. 2019
- Prevalence of adenomyosis as a co-morbidity in patients who underwent hysterectomy for other indications 2018
- Treatment options and reproductive outcome for adenomyosis-associated infertility 2017
- Spontaneous conception following GnRHa and progestogen therapy in adenomyosis 2016
- Effectiveness of treatment for infertility using clinical investigation of laparoscopy cytoreductive surgery combined with gestrinone in adenomyosis 2016
- Adenomyosis: What is New? 2015
- Current Treatment for Adenomyosis 2015
- National German Guideline (S2k): Guideline for the Diagnosis and Treatment of Endometriosis 2014
- Neurotrophin Expression Is Not Affected in Uteri of Women with Adenomyosis 2012
- Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings 2012
- Diagnostik und Therapie der Endometriose 2012
- Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist: Long-term follow-up in a series of nine patients 2012
- Adenomyosis and subfertility: a systematic review of prevalence, diagnosis, treatment and fertility outcomes 2012
- Infertility and Adenomyosis 2011
- Adenomyosis: Review of the Literature 2011
- Management of Adenomyosis in Subfertile Women and Pregnancy Outcome 2011
- Conservative surgical management for diffuse uterine adenomyosis 2009
- Is the surgical approach beneficial to subfertile women with symptomatic extensive adenomyosis? 2008
- Traitement de l'adénomyose 2007
- Tratamiento de la adenomiosis 2007
- Medical and surgical management of adenomyosis 2006
- Therapeutic options for adenomyosis: a review 2006
- Spontaneous uterine rupture of a twin pregnancy after a laparoscopic adenomyomectomy: A case report 2006
- Adénomyose 2006
- Use of laparoscopic cytoreductive surgery to treat infertile women with localized adenomyosis 2006
- Endokrine operative Therapie der Adenomyosis 2004
- Évolutions physiopathologiques, diagnostiques et thérapeutiques dans la prise en charge de l’adénomyose : revue de la littérature 2004
- Modified Reduction Surgery for Adenomyosis 2003
- Uterine adenomyosis in the infertility clinic 2003
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