OP22.05: Impact of adenomyosis on obstetric outcome after in vitro fertilisation

To examine the impact of adenomyosis on obstetric outcome after in vitro fertilisation. This is a prospective observational study in a population of women undergoing their first IVF cycle in two London teaching hospitals between April 2013 and October 2015. All women underwent a detailed transvaginal ultrasound scan prior to starting fertility treatment. The diagnosis of adenomyosis was made by visualisation of established ultrasonic criteria: an asymmetric myometrium, a globular shaped uterus, myometrial cysts and endometrial striae. We followed up all women and recorded the outcome of their IVF cycle. Women with other uterine pathology were not recruited in the study. During the study period 425 women were recruited. 66 women were excluded from further analysis for a variety of reasons. The prevalence of adenomyosis was 72/359 (20.1%, 95% CI 16.0 – 24.3). Clinical pregnancy rate was 143/359 (39.8%, 95% CI 34.7 – 44.9), miscarriage rate was 28/143 (19.6%, 95% CI 13.1 – 26.1) and 115/359 (32.0%, 95% CI 27.2 – 36.8) women had a livebirth. The median gestational age at delivery was 40.0 weeks (IQR 38.0 – 41.0), median birthweight was 3189 g (IQR 2807–3671) and median estimated blood loss 500 ml (IQR 300 – 812). There was no significant difference in median gestational age at delivery, median birthweight and median estimated blood loss between women with and without adenomyosis (40.0 weeks vs. 39.0 weeks, 3714 g vs. 3175 g and 600 ml vs. 500 ml) (p = 0.66, p = 0.97, p = 1.0). Our results suggest that adenomyosis diagnosed before assisted conception does not exert a large negative effect on obstetric outcome after IVF. However the power of our study is limited by a small sample size.