Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility?

Kishi Y, Yohei Kishi, Maki Yabuta, Yabuta M, Fumiaki Taniguchi, Taniguchi F
Fertility and sterility · 2014 · vol. 102(3) , pp. 802–807.e1 · doi:10.1016/j.fertnstert.2014.05.028 · PMID:24954774 · W2077495663
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This paper investigates which patients with adenomyosis-related infertility are most likely to benefit from uterus-sparing surgery.

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Abstract

ObjectiveTo analyze the determinants of successful pregnancy following laparoscopic adenomyomectomy.DesignRetrospective cohort study.SettingA general hospital.Patient(s)A total of 102 women who had a desire for pregnancy underwent laparoscopic adenomyomectomy from 2007 to 2012.Intervention(s)Surgical excision of the uterine adenomyosis; statistical analysis for fertility outcomes.Main outcome measure(s)Pregnancy rates and the results of univariable and multivariable analyses.Result(s)When the women were divided into ≤39 years and ≥40 years age groups, clinical pregnancy rates were 41.3% and 3.7%, respectively. Factors associated with clinical pregnancy were: history of IVF treatments, posterior wall involvements, and age, with odds ratios of 6.22, 0.18, and 0.77, respectively. In the younger group, 60.8% of women with history of IVF failure showed successful pregnancy after surgery. We experienced 2 cases of placenta accreta in far advanced cases.Conclusion(s)This study demonstrated age as a determinant in fertility outcomes. Surgery could be a beneficial treatment for women who experienced IVF treatment failures, especially at ages of ≤39 years. We could not show a clear benefit of the surgery on fertility outcomes of the group aged ≥40 years. Extremely severe adenomyosis affecting a broad range of the uterine subendomerial myometrium should be treated carefully on a pregnancy course.

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Condition tags

adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Infertility, Female Infertility, Female Organ Sparing Treatments Uterus Adenomyosis Adenomyosis Adult Female Humans Infertility, Female Infertility, Female Laparoscopy Middle Aged Organ Sparing Treatments Pregnancy Pregnancy Outcome Pregnancy Outcome Pregnancy Rate

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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.

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Cited by (50)

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