Type and Location of Adenomyosis in Women with Recurrent Pregnancy Loss: A Transvaginal Ultrasonographic Assessment

C. Exacoustós, Carlo Ticconi, Irene Colombi, Giuseppe Gabriele Iorio, E. Vaquero, Elena Vaquero, Aikaterini Selntigia, Barbara Chiaramonte, Giorgia Soreca, Giuseppe Rizzo
Reproductive sciences (Thousand Oaks, Calif.) · 2024 · vol. 31(8) , pp. 2447–2457 · doi:10.1007/s43032-024-01541-8 · PMID:38619796 · PMC11289184 · W4394812423
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This transvaginal ultrasonographic study found that adenomyosis, particularly in the inner myometrium, was associated with higher pregnancy losses and earlier age at first loss in women with recurrent pregnancy loss.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective observational case-control study assessed 120 women to examine whether adenomyosis is associated with recurrent pregnancy loss (RPL) and whether the type and myometrial localization of adenomyosis differ by RPL status; participants were grouped into women with RPL plus TV ultrasound–diagnosed adenomyosis, women with RPL without ultrasound evidence of adenomyosis, and women without RPL (at least one live birth) with ultrasound-diagnosed adenomyosis. Among women with RPL, those with adenomyosis had a higher number of pregnancy losses and had their first pregnancy loss at a younger age, with more frequent primary RPL, and adenomyosis of the inner myometrium was more common in the RPL-with-adenomyosis group than in the no-RPL adenomyosis group. No differences were found in the severity of adenomyosis between the RPL and non-RPL groups, and TV ultrasound findings suggestive of endometriosis were observed more frequently in women with adenomyosis without RPL than in the other groups. The paper’s limitation is that adenomyosis diagnosis relied on transvaginal ultrasound and MUSA criteria rather than histologic confirmation. This paper is centrally about adenomyosis — specifically how adenomyosis type and localization on transvaginal ultrasound relate to recurrent pregnancy loss.

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Abstract

The current knowledge on adenomyosis as a risk factor for RPL is very scant. Overall 120 women were included in this retrospective observational study. They were divided in three groups each of which consisted of 40 subjects: Group 1: women with RPL who were diagnosed to have adenomyosis on transvaginal ultrasound (TVS); Group 2: patients with RPL without ultrasonographic findings of adenomyosis; Group 3: patients with ultrasound diagnosis of adenomyosis without RPL and at least one live birth pregnancy. The copresence of endometriosis was also investigated. Among women with RPL, patients with adenomyosis (Group 1) had higher number of pregnancy losses (p = 0.03) and lower age at first pregnancy loss (p = 0.03) than women without adenomyosis (Group 2). Moreover, they had more frequently primary RPL (p = 0.008). Adenomyosis of the inner myometrium was found more frequently (p = 0.04) in patients of Group 1 than in patients of Group 3 in which adenomyosis was mainly in the outer myometrium (p= 0.02). No differences were found in the severity of adenomyosis between these two groups of women. TVS findings for endometriosis were observed more frequently in women with adenomyosis without RPL (Group 3) than in the other two groups of patients. Adenomyosis can be a factor involved in RPL. Differences in adenomyosis localization are associated with different risks for RPL. Patients with RPL should be investigated for the presence of adenomyosis and also for the type and localization of the disease in the different myometrial layers.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual Abortion, Habitual

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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