Évaluation de l’adénomyose avant et après injection d’analogue de la GnRH à partir d’un nouveau score échographique

Introduction: Adenomyosis is a benign gynecological condition characterized by the presence of ectopic endometrial tissue within the myometrium. Its pathophysiology remains poorly understood. According to Naftalin et al., the prevalence of adenomyosis in a symptomatic population is approximately 20%, making it a common condition and a real public health issue. Transvaginal ultrasound is the first-line imaging technique for its diagnosis. The main objective of this study is to demonstrate a significant improvement in adenomyosis lesions using a new standardized scoring system following the injection of a GnRH analogue.Methods: This was a prospective study conducted at the assisted reproduction center of the university hospital of Saint-Pierre (La Réunion, France). A standardized ultrasound score, based on the MUSA classification, was developed to assess the severity of adenomyosis before and after treatment. Each patient underwent a pelvic ultrasound examination both before and after treatment performed by the same operator to limit inter-observer bias.Results: Between the 5th of May and the 31st of October 2025, nine patients with adenomyosis were included in the study and received a single intramuscular injection of triptoreline 11.25 mg. A significant decrease in the ultrasound score was observed after treatment (Wilcoxon test, p = 0,00039; α < 0.05) reflecting an improvement in morphological abnormalities in all patients. This evolution suggests a favorable structural reorganization of the myometrium and a reduction in disease activity under the effect of triptoreline. These results are preliminary due to the small sample size but they highlight the value of a structured, reproducible ultrasound score specifically designed for the assessment of adenomyosis. The integration of this new tool into ultrasound reports could enable standardized descriptions, improve comparability between examinations, and facilitate the assessment of the impact of different therapeutic strategies in clinical practice.Conclusion: This pilot study suggests that a single intramuscular injection of triptoreline 11.25 mg may improve the ultrasound features of adenomyosis and restore a more favorable uterine environment for fertility. The proposed ultrasound score appears to be a simple and reproducible tool for monitoring this condition. However, larger multicenter studies are required to confirm these findings and to validate the score for routine clinical use.