Adenomyosis: clinical aspects, impact on fertility and pregnancy outcome

Р. И. Габидуллина, Angelina I. Kuptsova, Ekaterina A. Koshelnikova, F. R. NUHBALA, Rufat R. Bagirli, E. R. Mingaleva, Endzhe A. Khaliullina
In: Gynecology · 2020 · vol. 22(4) , pp. 55–61 · doi:10.26442/20795696.2020.4.200264 · W3086918570
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review examines adenomyosis prevalence, diagnosis, and treatment, highlighting its negative impact on fertility and pregnancy outcomes and discussing dienogest as a potential therapeutic agent.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This review summarizes the current state of knowledge about adenomyosis and its impact on women’s reproductive function, using a systematic literature search across MEDLINE, PubMed, EMBASE, Cochrane Library, and Elibrary. It reports that adenomyosis is common but insufficiently studied, that transvaginal ultrasound and MRI enable earlier diagnosis and organ-preserving surgery, and that evidence indicates negative effects on fertility and pregnancy outcomes, with severity associated with worse IVF and clinical pregnancy/live birth metrics. The review discusses risk factors, proposed pathogenesis theories, clinical manifestations, and notes a key limitation that diagnostic criteria are not unified, contributing to uncertainty in incidence and prevalence estimates, and that lifelong management plans are required with treatment choice depending on age and reproductive status. Relevance to endometriosis: the paper explicitly frames adenomyosis in the ICD as a specific form of endometriosis (“endometriosis of the uterus”) while arguing it is distinct from other endometriosis types, and it cites high co-occurrence of adenomyosis with endometriosis, making it centrally related to endometriosis and especially focused on adenomyosis.

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Abstract

Aim. To investigate the modern condition of the problem of adenomyosis and its impact on womens reproductive function. Material and methods. The article presents a systematic literature review on the results of research search in electronic databases MEDLINE, PubMed, EMBASE, Cochrane Library and Elibrary. Results. Adenomyosis is a common but insufficiently studied disease. Modern imaging methods, such as transvaginal ultrasound and MRI, make it possible to diagnose adenomyosis at the early stages of the disease and perform the organ-preserving surgery. A medical treatment of adenomyosis requires to develop a lifelong management plan, the choice depends on the womans age, reproductive status and clinical symptoms. Currently, there is evidence of a negative impact of adenomyosis on fertility and pregnancy outcomes. Dienogest, a 19-norsteroid derivative, is a progestin with high selectivity to progesterone receptors, it exerts a hypogonadotropic effect and an antiproliferative effect on the endometrium. A mild regime of supression of ovarian function provides adequate conditions for blood supply to the uterus before planning a pregnancy. The immunomodulating effect of progestin may be useful for implantation and fetal protection to pregnancies occurring after treatment. Dienogest treatment increases the effectiveness of IVF cycles for adenomyosis of varying severity. Conclusion. The review summarizes the aspects of prevalence, comorbidity, risk factors, classification, mechanism of pathogenesis, clinical manifestations, diagnosis, treatment of adenomyosis, impact on fertility and pregnancy outcomes.

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Condition tags

adenomyosis

Citation neighborhood

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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