Adenomyosis and infertility

Adenomyosis is a medical condition that affects a significant number of women around the world. It is identified by an abnormal growth of endometrial tissue within the muscle wall of the uterus. The exact cause of adenomyosis has not yet been scientifically proven, however several theories have been proposed. Clinical symptoms in patients affected by adenomyosis include abnormal uterine bleeding, dyspareunia, dysmenorrhea or infertility but one third of them may be without any symptoms. During the last years, adenomyosis has been identified as a condition found in young fertile-age women due to the recent advancements in imaging studies. Despite of that, a common definition and classification system are still lacking. Regarding the management and the treatment plan of adenomyosis, there are medical as well as surgical options. The medical therapies for adenomyosis aim to treat local hyperestrogenism and alleviate the most severe symptoms of adenomyosis. Adenomyosis has also been significantly associated with an increased risk of obstetric complications and negative effects on fertility after assisted reproductive technology. This study reviewed the articles about adenomyosis and infertility published in PubMed in the last five years. Women with adenomyosis undergoing assisted reproductive technology treatment, have been found to have lower clinical pregnancy rates and live birth rates compared to women without adenomyosis. However, the impact of adenomyosis on IVF outcomes may be dependent on the severity and extent of the disease, with some studies reporting that patients with mild to moderate adenomyosis may not experience significant reductions in IVF success rates. The optimal management strategy for women with adenomyosis undergoing IVF remains controversial, and further research is needed to determine the most effective treatment options for this patient population.