Fertility-Sparing Treatment of Adenomyosis in Patients With Infertility: A Systematic Review of Current Options

Tainá Pezzin Rocha, Marina Paula Andres, Giuliano Moysés Borrelli, Mauricio Simões Abrão, Maurício Simões Abrão
Reproductive sciences (Thousand Oaks, Calif.) · 2018 · vol. 25(4) , pp. 480–486 · doi:10.1177/1933719118756754 · PMID:29402199 · W2790503382
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-10 ⓘ

This review found that GnRH analogues improve pregnancy rates after conservative adenomyosis surgery and that long stimulation protocols yield better ART outcomes for adenomyosis-associated infertility.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This systematic review assessed reproductive outcomes of fertility-sparing (conservative) treatments for adenomyosis-associated infertility by searching PubMed/Medline for English-language studies from the prior 7 years and including 16 studies. Six studies evaluated surgical uterine-conserving approaches, finding a very low overall spontaneous clinical pregnancy rate (18.2%), while the pooled spontaneous pregnancy rate increased when GnRH analogues were used for 24 weeks after surgery (40.7% vs 15.0%); other outcomes were not significantly different. Ten studies evaluated assisted reproductive techniques, where long stimulation protocols outperformed short protocols for pregnancy rate (43.3% vs 31.8%), live birth (43.0% vs 23.1%), and miscarriage (18.5% vs 31.1%). A major limitation is that the evidence base comprised heterogeneous small studies, and the review does not fully address comparability across treatment types and protocols. This paper is centrally about adenomyosis — it systematically reviews fertility-sparing treatment options for adenomyosis-associated infertility and their reproductive outcomes.

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Abstract

Adenomyosis is a benign gynecological disease observed in women in their reproductive age. Recent studies have shown that adenomyosis might be a relevant factor for infertility, either impairing implantation or leading to early miscarriage. However, conservative treatment of infertility related to adenomyosis is still unclear. This study systematically reviews the literature for the reproductive outcomes of the available conservative treatments for patients with adenomyosis-associated infertility. We conducted a search in PubMed/Medline for studies in English published in the last 7 years and included 16 studies. Six studies evaluated surgical treatments of adenomyosis. When considering only spontaneous pregnancies, the overall clinical pregnancy rate was very low (18.2%). However, when using GnRH analogues for 24 weeks after surgery, the pooled spontaneous pregnancy rate was higher (40.7% vs 15.0%; P =.002). No significant difference was observed in the other outcomes. Ten studies evaluated exclusive assisted reproductive techniques for infertility related to adenomyosis and showed that the long stimulation protocol had better outcomes compared to short stimulation protocol in pregnancy rate (43.3% vs 31.8%; P =.0001), live birth (43.0% vs 23.1 %; P =.005), and miscarriage (18.5% vs 31.1 %; P <.0001). Similar content being viewed by others

References

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Reprod. Sci. 25, 480–486 (2018). https://doi.org/10.1177/1933719118756754 Published: Version of record: Issue date: DOI: https://doi.org/10.1177/1933719118756754

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Condition tags

adenomyosisinfertility

MeSH descriptors

Adenomyosis Fertility Preservation Infertility, Female Reproductive Techniques, Assisted Adenomyosis Female Fertility Preservation Fertilization in Vitro Humans Infertility, Female Pregnancy Pregnancy Outcome Pregnancy Rate

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