Women with combined adenomyosis and endometriosis on MRI have worse IVF/ICSI outcomes compared to adenomyosis and endometriosis alone: A matched retrospective cohort study

Connie O Rees, C.O. Rees, Rees CO, Iris A M Rupert, Rupert IAM, Joost Nederend, D. Consten, Dimitri Consten, Consten D, Massimo Mischi, A A M van Vliet H, Huib A A M van Vliet, Benedictus C Schoot, B.C. Schoot, Schoot BC
European journal of obstetrics, gynecology, and reproductive biology · 2022 · vol. 271 , pp. 223–234 · doi:10.1016/j.ejogrb.2022.02.026 · PMID:35231748 · W4213448453
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Women undergoing IVF/ICSI with both adenomyosis and endometriosis detected via MRI experienced worse outcomes than those with either condition alone.

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Abstract

Study objectivesTo assess the effect of adenomyosis, endometriosis and combined adenomyosis and endometriosis, diagnosed on MRI, on IVF/ICSI outcomes versus male subfertility controls.Study designThis single-centre matched retrospective cohort study was carried out at Catharina Hospital in Eindhoven, The Netherlands. The study group consisted of infertile women undergoing their first, fresh embryo transfer during IVF/ICSI, with adenomyosis only (N = 36), endometriosis only (N = 61), and combined adenomyosis and endometriosis (N = 93) based on MRI. The control group consisted of IVF/ICSI patients undergoing treatment due to male subfertility (N = 889). 1:2 case-control matching based on age during IVF/ICSI, parity and number of embryos transferred was performed. Odds ratios were calculated for biochemical pregnancy, ongoing pregnancy and live birth rate versus matched male subfertility controls, and were corrected for embryo quality.ResultsOnly the combined adenomyosis and endometriosis group showed a significantly reduced OR for biochemical pregnancy (p = 0.004, OR 0.453 (95% CI :(0.284-0.791)), ongoing pregnancy (p = 0.001, OR 0.302 (95% CI: (0.167-0.608)) and live birth (p = 0.001, OR 0.309 (95% CI: (0.168-0.644)) compared to matched male subfertility controls.ConclusionsThe lower (ongoing) pregnancy and live birth rates in the combined adenomyosis and endometriosis women can be attributed to more severe disease in these women, ultimately resulting in increased chances for failed implantation and miscarriage. This highlights the importance of screening for adenomyosis in endometriosis patients, and identifies these women target for additional (hormonal) treatment prior to IVF/ICSI.

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Condition tags

endometriosisadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Endometriosis Endometriosis Endometriosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Female Fertilization in Vitro Fertilization in Vitro Humans Live Birth Magnetic Resonance Imaging Male Pregnancy Pregnancy Rate Retrospective Studies

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