Adenomyosis: a cause of "unexplained" female infertility

Arbouni, Hind
2022 · doi:10.26044/ecr2022/c-15758 · W6946332974
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This retrospective study of 30 patients demonstrates that adenomyosis, diagnosed via imaging, is associated with infertility and pelvic symptoms, potentially due to myometrial contractile disturbances and hyperestrogenism.

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This retrospective study analyzed thirty patients with primary or secondary infertility to evaluate the role of adenomyosis in reproductive failure. The research identified specific imaging markers on ultrasound and MRI, such as myometrial wall asymmetry and subendometrial microcysts, which characterize the condition. The authors conclude that adenomyosis disrupts myometrial contractility and local estrogen levels, potentially causing implantation anomalies that can be mitigated by GnRH agonists during IVF cycles. This paper is centrally about adenomyosis — specifically its association with unexplained female infertility and diagnostic imaging features.

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Keywords

Genital / Reproductive system female, Pelvis, MR, Ultrasound, Ultrasound-Colour Doppler, Ablation procedures, Education, Localisation, Cancer, Pathology Authors: H. Arbouni, H. hilal, H. E. azouazi, D. LAOUDIYI, K. CHBANI, S. SALAM, L. OUZIDANE DOI: 10.26044/ecr2022/C-15758 Purpose Know how to recognize adenomyosis on imaging Identify the pathologies that are frequently associated with it in order to guide the therapeutic management of symptomatic patients. To know the role of adenomyosis in female infertility

Methods

and materials It is a retrospective study on 30 patients Location: Radiology department of the CHU Casablanca, Periods: 3 years : (from February 2018 to February 2021) Inclusion criteria: primary or secondary infertility associated with adenomyosis diagnosed by ultrasound and/or MRI

Results

The average age was 41 years with extremes of age between 37 and 46 years Our patients had a history of: multiparity (20 cases); miscarriage (5 cases); myomectomy (7 cases) and breast cancer under Tamoxifen (3 cases) Clinically, the patients had: primary or secondary infertility(25cases); metrorrhagia(20cases) and pelvic pain(20cases) The radiological findings on ultrasound and MRI were: asymmetry of the myometrial walls (22 cases); thickening of the endometrial/myometrial junction of the endometrium/myometrium junction (20 cases); subendometrial microcysts (18 cases); heterogeneous appearance of the myometrium (18...

Conclusion

Adenomyosis is related to the invagination of endometrial islets within the myometrium, leading to a disturbance of the contractile activity of the myometrium contractile activity of the latter, also potentiated by local hyperestrogenism. Diagnosis is based on imaging: ultrasound and MRI Medical and surgical treatments are disappointing, with the exception of GnRH agonists, which allow compensation in IVF/ICSI, which makes it possible to compensate for the implantation anomalies observed in this pathology. Personal information and conflict of interest H. Arbouni: Nothing to disclose H. hilal: Nothing to disclose h. e. azouazi: Nothing to disclose D. LAOUDIYI: Nothing to disclose K. CHBANI: Nothing to disclose S. SALAM: Nothing to disclose L. OUZIDANE: Nothing to disclose

References

1: Imaging features of adenomyosis Author links open overlay panelM.Bazot(Praticien hospitalier)aJ.Nassar-Slaba(Interne)aJ.Rouger(Attaché)aA.Cortez(Praticien hospitalier)bE.Daraï(Professeur des Universités, praticien hospitalier) 2:Mise au point sur l’adénomyose - 10/01/13 Doi : 10.1016/j.jradio.2012.06.009 G. Levy a, ⁎ , A. Dehaene a, N. Laurent a, b, M. Lernout a, c, P. Collinet d, J.-P. Lucot d, C. Lions a, E. Poncelet a,

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adenomyosisinfertility

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