Long-Term Pregnancy Outcomes of Patients with Diffuse Adenomyosis after Double-Flap Adenomyomectomy

Yong Zhou; Li Shen; Yuan Wang; Mengjia Yang; Zhengyun Chen; Xinmei Zhang

doi:10.3390/jcm11123489

Long-Term Pregnancy Outcomes of Patients with Diffuse Adenomyosis after Double-Flap Adenomyomectomy

Yong Zhou, Li Shen, Yuan Wang, Mengjia Yang, Zhengyun Chen, Xinmei Zhang

Journal of clinical medicine · 2022 · vol. 11(12) , pp. 3489 · doi:10.3390/jcm11123489 · PMID:35743559 · W4283021983

article OA: gold CC0 ⤵ 8 in-corpus citations

🔓 Open OA copy View on OpenAlex View on PubMed View at publisher

Abstract

Although many studies show that patients with diffuse adenomyosis who underwent fertility-sparing surgery can have a successful pregnancy, their pregnancy outcomes are still controversial. The objective of this study was to determine long-term pregnancy outcomes and possible influencing factors after double-flap adenomyomectomy for patients with diffuse adenomyosis. A total of 137 patients with diffuse adenomyosis who underwent double-flap adenomyomectomy between January 2011 and December 2019 were studied, and correlations between pregnancy outcomes and clinical data, including age and junctional zone measured by magnetic resonance imaging (JZmax-A), were analyzed. The results show that 56 patients (40.9%, 56/137) had 62 pregnancies, including 35 natural pregnancies and 27 assisted reproduction pregnancies, after operation. A univariate regression analysis showed that the pregnancy outcomes were related to age at surgery, visual analog scale (VAS) score of preoperative dysmenorrhea, parity experience, length of infertility, and postoperative JZmax-A. A multivariate regression analysis showed that age at surgery, VAS score of preoperative dysmenorrhea, and postoperative JZmax-A were the independent indicators correlated with pregnancy outcomes. A receiver operating characteristic curve analysis showed that postoperative JZmax-A was the most valuable indicator for predicting pregnancy outcomes. Cumulative pregnancy rates during the first 3 years were 70.1% and 20.9% in the postoperative JZmax-A ≤ 8.5 mm and the postoperative JZmax-A > 8.5 mm groups, respectively. In conclusion, double-flap adenomyomectomy could improve fertility for diffuse adenomyosis, and postoperative JZmax-A might be a promising indicator for predicting pregnancy outcomes.

My notes (saved in your browser only)

Outcome instruments

VAS-pain

Condition tags

adenomyosisdysmenorrheainfertility

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.

References (27)

Cited by (8)

Source provenance

europepmc: last seen: 2026-06-04T01:30:01.192114+00:00
openalex: last seen: 2026-06-04T00:00:01.174412+00:00
pubmed: last seen: 2026-05-29T00:34:38.813996+00:00

License: CC0 · commercial use OK

[1] A comparison of reproductive outcomes of patients with adenomyosis and infertility treated with High-Intensity focused ultrasound and laparoscopic excision via openalex

[2] Adenomyosis in infertile women: prevalence and the role of 3D ultrasound as a marker of severity of the disease via openalex

[3] Diagnosing adenomyosis with MRI: a prospective study revisiting the junctional zone thickness cutoff of 12 mm as a diagnostic marker via openalex

[4] Does presence of adenomyosis affect reproductive outcome in IVF cycles? A retrospective analysis of 973 patients via openalex

[5] Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis via openalex

[6] Fertility-Sparing Treatment of Adenomyosis in Patients With Infertility: A Systematic Review of Current Options via openalex

[7] Is the surgical approach beneficial to subfertile women with symptomatic extensive adenomyosis? via openalex

[8] <p>Comparisons of the efficacy and recurrence of adenomyomectomy for severe uterine diffuse adenomyosis via laparotomy versus laparoscopy: a long-term result in a single institution</p> via openalex

[9] Magnetic resonance imaging features influencing high-intensity focused ultrasound ablation of adenomyosis with a nonperfused volume ratio of ≥90% as a measure of clinical treatment success: retrospective multivariate analysis via openalex

[10] Management of Adenomyosis in Subfertile Women and Pregnancy Outcome via openalex

[11] Reproductive, obstetric, and perinatal outcomes of women with adenomyosis and endometriosis: a systematic review and meta-analysis via openalex

[12] Reproductive Outcomes after Fertility-Sparing Surgery for Focal and Diffuse Adenomyosis: A Systematic Review via openalex

[13] Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis via openalex

[14] The association between adenomyosis and recurrent miscarriage via openalex

[15] The Outcome of Fertility-Sparing and Nonfertility-Sparing Surgery for the Treatment of Adenomyosis. A Systematic Review and Meta-analysis via openalex

[16] Treatment of adenomyomectomy in women with severe uterine adenomyosis using a novel technique via openalex

[17] Ultrasound-guided transcervical radiofrequency ablation for symptomatic uterine adenomyosis via openalex

[18] Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery via openalex

[19] Uterine adenomyosis and in vitro fertilization outcome: a systematic review and meta-analysis via openalex

[20] Uterine adenomyosis in the infertility clinic via openalex

[21] Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility? via openalex

[22] W2082364885 via openalex

[23] W2048000815 via openalex

[24] W2783955040 via openalex

[25] W2591907303 via openalex

[26] W2106181357 via openalex

[27] W2103966730 via openalex