Adenomyosis a forgotten cause of infertility

Objectives: To review whether adenomyosis causes infertility or not, the current available methods of its diagnosis, the lines of ade- nomyosis associated infertility treatment, and why future research is needed. Materials and methods: Electronic databases for studies on adeno- myosis and infertility published between 1995-2020 were searched and reviewed using the PUBMED as a search engine. The follow- ing keywords were used: adenomyosis, infertility, ultrasonography, MRI, IVF/ICSI, cytoreductive surgery, GnRHa, NSAIDs and HIFU. No language limitations were applied. Findings: Adenomyosis is a disease of women in reproductive age and contributes to infertility. It can be accurately diagnosed by non invasive imaging. There are different lines of treatment of adenomy- osis associated infertility. However all currently available methods have their limitations. There is a need to expand research in this area to be able to answer the enigma of adenomyosis and infertility. Conclusion: Reproductive medicine physicians should be aware of the possible contribution of adenomyosis to infertility and look for its presence during infertility workup. This will enable them to prop- erly counsel the patients and choose the most appropriate methods for management of their infertility.