OC24.06: In vitro fertilisation does not affect the sonographic characteristics of adenomyosis

Estrogen is involved in the pathogenesis of adenomyosis and it rises considerably during in vitro fertilisation (IVF) cycles. This study aims to assess the impact of ovarian hyperstimulation for IVF on the sonographic characteristics of adenomyosis. This prospective cohort study was performed between October 2012 and March 2015. The study included women with adenomyosis (diagnosed by transvaginal ultrasonography and confirmed by magnetic resonance imaging). Exclusion criteria were: previous uterine surgery, uterine myomas, uterine malformations. Patients with adenomyosis scheduled for their first IVF-ICSI cycle were considered for study entry. Eligible patients were scanned before the IVF cycle; the patients who failed to conceive were included in the study and were scanned again within two months after the IVF cycle. 31 women with adenomyosis were included in the study (mean age, 36.2 years). The mean (± SD) total dose of FSH administered was 2752 (± 1107) I.U.; the mean length of stimulation was 11.8 (± 1.8) days. Uterine volume was similar before and after the IVF cycle (296 ± 83 cm3 and 301 ± 85 cm3; p = 0.290). The mean maximal junctional zone thickness (JZmax) was 16.4 (± 2.6) mm before IVF and 16.2 (± 2.3) mm after IVF (p = 0.946). There was no significant difference in the JZmax to myometrial thickness ratio before and after IVF (p = 0.134). Myometrial cysts were identified in 14 patient after IVF (45.2%), 13 of them had myometrial cyst prior to IVF; the size of these cyst did not significantly change after IVF (p = 0.240). Subendometrial linear striations were observed in 54.8% of the patients before IVF and in 61.3% after IVF (p = 0.797). One IVF cycle does not have a significant effect on the sonographic characteristics of adenomyosis. Future studies should assess whether multiple IVF cycles have a different effect on adenomyosis. If the results of this study are confirmed, patients with adenomyosis undergoing IVF could be reassured that ovarian stimulation does not promote the progression of their disease.