Adenomyosis and infertility

Gaby Moawad, Mira H Kheil, Mira Kheil, Jean Marc Ayoubi, Jordan S Klebanoff, Sara Rahman, Fady I Sharara
Journal of assisted reproduction and genetics · 2022 · vol. 39(5) , pp. 1027–1031 · doi:10.1007/s10815-022-02476-2 · PMID:35347501 · PMC9107544 · W4220925860
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

This review explored the relationship between adenomyosis and infertility, finding lower pregnancy rates and higher miscarriage rates in affected patients.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 · read from full text ⓘ

This review examined the relationship between adenomyosis and infertility by searching PubMed/Medline for studies (systematic reviews, meta-analyses, observational studies, and randomized trials) reporting pregnancy and fertility outcomes, particularly after assisted reproductive technology (ART). Across multiple meta-analyses and cohorts, women with adenomyosis showed lower clinical pregnancy rates and higher miscarriage rates, with live birth outcomes sometimes not significantly different after adjustment (including matching for endometriosis), and the review notes limitations including study bias from lack of unified diagnostic criteria and confounding from frequent comorbidities like endometriosis and leiomyomas. The review also reports that treatment is associated in the literature with higher pregnancy and live birth rates, while adverse obstetric outcomes such as preterm delivery and preterm premature rupture of membranes have been described. This paper is centrally about adenomyosis — specifically its association with infertility, ART outcomes, miscarriage risk, obstetric outcomes, and reported effects of treatment.

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Full text 7,336 characters · extracted from oa-doi-fallback · 5 sections · click to expand

Abstract

Purpose Adenomyosis is a poorly understood entity with no unified treatment protocol. It has been thought to only affect the quality of life of older women, but growing evidence is highlighting the increased frequency of adenomyosis in younger patients and its possible effects on fertility outcomes. This can have a great impact on how clinicians screen, diagnose, and treat this condition. The aim of this review is to explore the relationship between adenomyosis and infertility.

Methods

A literature search of the keywords “adenomyosis”, “infertility”, “pregnancy” and “fertility” was conducted using the PubMed and Medline search engines. The articles selected were observational, systematic reviews, meta-analyses, and randomized controlled trials. The search was limited to English, abstracts were screened, and articles were selected.

Results

The literature reports lower clinical pregnancy rates, lower live birth rates, higher miscarriage rates, and higher odds of adverse obstetric outcomes in patients with adenomyosis. Treatment seems to be associated with higher pregnancy rates and live births rates.

Conclusion

An association between adenomyosis and infertility seems to exist, and treatment could lead to improved fertility outcomes. Access this article We’re sorry, something doesn't seem to be working properly. Please try refreshing the page. If that doesn't work, please contact support so we can address the problem. Similar content being viewed by others

References

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Systematic review and meta-analysis of adverse pregnancy outcomes after uterine adenomyosis. Int J Gynaecol Obstet. 2019;145(2):149–57. Vannuccini S, et al. Role of medical therapy in the management of uterine adenomyosis. Fertil Steril. 2018;109(3):398–405. Grimbizis GF, Mikos T, Tarlatzis B. Uterus-sparing operative treatment for adenomyosis. Fertil Steril. 2014;101(2):472–87. Younes G, Tulandi T. Conservative Surgery for Adenomyosis and Results: A Systematic Review. J Minim Invasive Gynecol. 2018;25(2):265–76. Rocha TP, et al. Fertility-Sparing Treatment of Adenomyosis in Patients With Infertility: A Systematic Review of Current Options. Reprod Sci. 2018;25(4):480–6. Tan J, et al. Reproductive Outcomes after Fertility-Sparing Surgery for Focal and Diffuse Adenomyosis: A Systematic Review. J Minim Invasive Gynecol. 2018;25(4):608–21. Xie M, et al. Elasticity of adenomyosis is increased after GnRHa therapy and is associated with spontaneous pregnancy in infertile patents. J Gynecol Obstet Hum Reprod. 2019;48(10):849–53. Goldberger MA, Marshak RH, Hermel M. Roentgen diagnosis of adenomyosis uteri. Am J Obstet Gynecol. 1949;57(3):563–8. Stamatopoulos CP, et al. Value of magnetic resonance imaging in diagnosis of adenomyosis and myomas of the uterus. J Minim Invasive Gynecol. 2012;19(5):620–6. Novellas S, et al. MRI Characteristics of the Uterine Junctional Zone: From Normal to the Diagnosis of Adenomyosis. Am J Roentgenol. 2011;196(5):1206–13. Kepkep K, et al. Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? Ultrasound Obstet Gynecol. 2007;30(3):341–5. Dueholm M. Transvaginal ultrasound for diagnosis of adenomyosis: a review. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):569–82. Struble J, Reid S, Bedaiwy MA. Adenomyosis: A Clinical Review of a Challenging Gynecologic Condition. J Minim Invasive Gynecol. 2016;23(2):164–85. Cakmak H, Taylor HS. Implantation failure: molecular mechanisms and clinical treatment. Hum Reprod Update. 2011;17(2):242–53. Harada T, et al. The Impact of Adenomyosis on Women’s Fertility. Obstet Gynecol Surv. 2016;71(9):557–68. Author information Authors and Affiliations Contributions All authors contributed equally to this review paper. Corresponding author Ethics declarations Conflict of interest The authors have no relevant financial or non-financial interests to disclose. Additional information Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Moawad, G., Kheil, M.H., Ayoubi, J.M. et al. Adenomyosis and infertility. J Assist Reprod Genet 39, 1027–1031 (2022). https://doi.org/10.1007/s10815-022-02476-2 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s10815-022-02476-2

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Condition tags

adenomyosisinfertility

MeSH descriptors

Abortion, Spontaneous Abortion, Spontaneous Abortion, Spontaneous Abortion, Spontaneous Abortion, Spontaneous Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female Female Female Female Female

Citation neighborhood

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