Association between Uterine Adenomyosis and Infertility: Role of Axonemal Alteration in Apical Endometria

Khaleque Newaz Khan; Khaleque N Khan

doi:10.4103/ejpi.ejpi-d-24-00032

Association between Uterine Adenomyosis and Infertility: Role of Axonemal Alteration in Apical Endometria

Khaleque Newaz Khan, Khaleque N Khan

Journal of physiological investigation · 2024 · vol. 67(2) , pp. 57–63 · doi:10.4103/ejpi.ejpi-d-24-00032 · PMID:38780290 · W4396522115

review OA: gold CC0 ⤵ 1 in-corpus citation

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

This study critically analyzes literature data to explain infertility in adenomyosis patients, highlighting recent findings of microvilli damage and axonemal alteration in apical endometria due to inflammation.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

ABSTRACT: Uterine adenomyosis is an estrogen-dependent chronic inflammatory condition and may cause painful symptoms, abnormal uterine bleeding, and/or subfertility/infertility. It is characterized by the presence of endometrial glands and stroma within the myometrium causing enlargement of the uterus as a result of reactive hyperplastic and/or hypertrophic change of the surrounding myometrium. Similar to endometriosis, adenomyosis has a negative impact on female fertility. Abnormal uterotubal sperm transport, tissue inflammation, and the toxic effect of chemical mediators have been proposed as contributing factors. Inflammation-induced damage of the mucosal cilia in the fallopian tube has been reported. Besides other proposed mechanisms, our most recent study with transmission electron microscopy analysis indicated that microvilli damage and an axonemal alteration in the apical endometria occur in response to endometrial inflammation. This may be involved in the negative fertility outcome in women with adenomyosis. We present a critical analysis of the literature data concerning the mechanistic basis of infertility in women with adenomyosis and its impact on fertility outcome.

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Condition tags

endometriosisadenomyosisinfertility

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Endometrium Endometrium Endometrium Endometrium Endometrium Endometrium Endometrium Infertility, Female Infertility, Female Infertility, Female Infertility, Female Infertility, Female

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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Cited by (1)

Adenomyosis and chronic endometritis: cause, consequence or coincidence? A systematic review and meta-analysis 2026

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: 2026-05-19T00:32:33.074583+00:00

License: CC0 · commercial use OK

[1] Adenomyosis: via openalex

[2] Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study via openalex

[3] Adenomyosis and Subfertility: Evidence of Association and Causation via openalex

[4] Adenomyosis does not affect implantation, but is associated with miscarriage in patients undergoing oocyte donation via openalex

[5] Adenomyosis: epidemiological factors via openalex

[6] Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging via openalex

[7] Adenomyosis in the baboon is associated with primary infertility via openalex

[8] Adenomyosis: Mechanisms and Pathogenesis via openalex

[9] An axonemal alteration in apical endometria of human adenomyosis via openalex

[10] A prospective cohort study of endometriosis and subsequent risk of infertility via openalex

[11] Asymptomatic adenomyosis and embryo implantation in IVF cycles via openalex

[12] Biological differences between focal and diffuse adenomyosis and response to hormonal treatment via openalex

[13] Biological differences between functionalis and basalis endometria in women with and without adenomyosis via openalex

[14] Biological differences between intrinsic and extrinsic adenomyosis with coexisting deep infiltrating endometriosis via openalex

[15] Changes in tissue inflammation, angiogenesis and apoptosis in endometriosis, adenomyosis and uterine myoma after GnRH agonist therapy via openalex

[16] Complications and outcomes of pregnant women with adenomyosis in Japan via openalex

[17] Constitutive and tumor necrosis factor-α-induced activation of nuclear factor-κB in adenomyosis and its inhibition by andrographolide via openalex

[18] Differential macrophage infiltration in early and advanced endometriosis and adjacent peritoneum via openalex

[19] Epidemiology of Adenomyosis via openalex

[20] Estrogen receptor-alpha (ER-alpha) and defects in uterine receptivity in women via openalex

[21] Four subtypes of adenomyosis assessed by magnetic resonance imaging and their specification via openalex

[22] High endometrial aromatase P450 mRNA expression is associated with poor IVF outcome via openalex

[23] HOXA10 expression is decreased in endometrium of women with adenomyosis via openalex

[24] Induction of endometriotic nodules in an experimental baboon model mimicking human deep nodular lesions via openalex

[25] Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis via openalex

[26] Occurrence of chronic endometritis in different types of human adenomyosis via openalex

[27] Pathogenesis of Human Adenomyosis: Current Understanding and Its Association with Infertility via openalex

[28] Pathophysiology of adenomyosis via openalex

[29] Prevalence and risk factors of adenomyosis at hysterectomy via openalex

[30] Relationship between the magnetic resonance imaging appearance of adenomyosis and endometriosis phenotypes via openalex

[31] Structural abnormalities of the uterine wall in women with endometriosis and infertility visualized by vaginal sonography and magnetic resonance imaging via openalex

[32] Structural and molecular features of the endomyometrium in endometriosis and adenomyosis via openalex

[33] The distribution of immune cells and macrophages in the endometrium of women with recurrent reproductive failure. II: adenomyosis and macrophages via openalex

[34] The elusive adenomyosis of the uterus—revisited via openalex

[35] The Pathogenesis of Adenomyosis vis-à-vis Endometriosis via openalex

[36] The potential value of magnetic resonance imaging in infertility via openalex

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

[38] Uterine adenomyosis: a need for uniform terminology and consensus classification via openalex

[39] Uterine adenomyosis in the infertility clinic via openalex

[40] W6784688324 via openalex

[41] W168208786 via openalex

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