Pathogenesis and treatment status of adenomyosis complicated with infertility

Adenomyosis (AD) refers to the endometrium (including glands and stroma) into myometrium growth of pathological changes, with the delay of women's childbearing age, the patients with AD-associated infertility increased significantly. Although scholars disagreed about the effect of AD on infertility, more and more evidence showed that AD was closely related to the structural and functional defects of the eutopic endometrium and myometrial junctional zone (MJZ), which may lead to embryo implantation failure and infertility. With the rapid development of imaging technology, the accuracy of diagnose AD has been enhanced, more and more infertility patients were diagnosed with AD. At the same time, a series of pathogenic hypothesis have been proposed to explain the relationship between AD. In addition, AD may influence the patient’s reproductive function by affecting sperm transport, embryo implantation, altering uterine peristalsis, influencing the structure and function of endometrium, and changing the intrauterine environment. At present, the treatment of AD-associated infertility is similar to the treatment of AD. The commonly used treatment methods include drug therapy, conservative operative treatment, drug combination surgery, and Chinese medicine treatment and so on. The clinical and experimental studies of AD complicated with infertility and its possible pathogenesis and treatment in recent years are reviewed in this article.