Adenomyosis and Subfertility: Evidence of Association and Causation

Carla Tomassetti, Christel Meuleman, Dirk Timmerman, D. Timmerman, Thomas D'Hooghe, Thomas D’Hooghe
Seminars in reproductive medicine · 2013 · vol. 31(02) , pp. 101–108 · doi:10.1055/s-0032-1333475 · PMID:23446857 · W2036119242
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This paper reviews evidence linking adenomyosis to subfertility, including baboon studies, impaired ART outcomes, and abnormal uterine contractility, while noting the need for better human studies.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This paper synthesizes limited existing evidence on whether adenomyosis causes infertility, highlighting the difficulty of testing causality because endometriosis may be confounded or unrecognized in both cases and controls. Drawing on available studies, it reports evidence supporting a causal association: adenomyosis is linked with lifelong infertility in baboons, with impaired reproductive outcomes after assisted reproductive techniques, and with a dose–effect relationship between adenomyosis severity and abnormal uterotubal contractility. The paper explicitly states that more and better designed studies are needed in women with laparoscopically confirmed presence or absence of endometriosis to clarify adenomyosis’s impact on infertility. Relevance to endometriosis: the paper discusses the confounding presence of endometriosis in infertility studies and frames the evidence as difficult to interpret unless endometriosis status is determined, though its main focus is adenomyosis and causation in subfertility.

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Abstract

Due to the confounding or unknown presence of endometriosis in both cases and controls, it is difficult to test the hypothesis that adenomyosis causes infertility. Based on the limited available evidence, there is evidence to support a causal association between adenomyosis and subfertility: Adenomyosis is associated with lifelong infertility in baboons, is associated with impaired reproductive outcome after assistive reproductive technique, and a dose-effect relationship between the degree of adenomyosis and the degree of abnormal uterotubal contractility has been demonstrated. More and better designed studies are needed to assess the impact of adenomyosis on infertility in women with the laparoscopic-proven presence or absence of endometriosis.

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Condition tags

endometriosisadenomyosisinfertility

MeSH descriptors

Adenomyosis Infertility, Female Adenomyosis Adenomyosis Animals Causality Disease Models, Animal Female Humans Infertility, Female Infertility, Female Infertility, Female Pregnancy Pregnancy Outcome Pregnancy Rate Prevalence Reproductive Techniques, Assisted Severity of Illness Index

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

Cited by (50)

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