Adenomyosis

In: Ultrasonography in Reproductive Medicine and Infertility · 2010 · pp. 126–133 · doi:10.1017/cbo9780511776854.018 · W1016739895
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AI-generated summary by claude@2026-06+body, 2026-06-13

Adenomyosis, characterized by endometrial tissue in the myometrium, is diagnosed using ultrasonography, considering patient history and physical signs, and may be associated with infertility.

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This chapter reviews ultrasonography for adenomyosis within the broader context of reproductive medicine and infertility, describing the typical clinical and pathologic features and how they relate to imaging findings. It notes that adenomyosis is pathologically confirmed by ectopic endometrial glands and stroma within the myometrium, which is associated with adjacent smooth-muscle hyperplasia and hypertrophy leading to uterine enlargement. The chapter emphasizes that sonographic diagnosis is challenging because fibroids and adenomyosis can be confused, and that subtle increased myometrial echogenicity may be best seen with higher-resolution ultrasound; it also states that diagnosis should integrate the history, sonographic features, and tenderness rather than rely on ultrasound appearance alone. It relates to endometriosis because the chapter contrasts adenomyosis pathology to ectopic endometrial elements and is situated in an ultrasonography section that also includes pelvic endometriosis. This paper is centrally about adenomyosis — it focuses on how adenomyosis is clinically, pathologically, and sonographically assessed in reproductive medicine and infertility.

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- Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index from Section 2: - Ultrasonography in infertility Published online by Cambridge University Press: 07 September 2011 Edited by Book contents - Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index Clinically, adenomyosis is usually seen in women in their thirties but has been seen from the early twenties into the postmenopausal period. Pathologically, adenomyosis is confirmed if there are ectopic endometrial glands and stroma in the myometrium. This induces hyperplasia and hypertrophy of the adjacent smooth muscle, causing uterine enlargement. The sonographic diagnosis of fibroids has long been confused with that of adenomyosis. Leiomyomata or fibroids are common in women, with an increased incidence of 7 times in blacks and nulliparous women. In adenomyosis, the myometrium has areas of increased echogenicity that may be subtle and best appreciated with higher-resolution ultrasound scanners. The diagnosis of adenomyosis should not depend only on the sonographic appearance but must rather consider the whole picture or triad of history, sonographic features, and signs of tenderness. Adenomyosis has been suspected as cause of infertility. The treatment of adenomyosis is mainly symptomatic. - Type - Chapter - Information - Ultrasonography in Reproductive Medicine and Infertility , pp. 126 - 133Publisher: Cambridge University PressPrint publication year: 2010 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - Adenomyosis - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Adenomyosis - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Adenomyosis - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011

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