Adenomyosis: what is the impact on fertility?
OBJECTIVE
This review is timely and relevant for several reasons. The incidence of adenomyosis begins to rise from the mid-thirties. Moreover, more women are delaying their first pregnancy until later in their thirties or forties, and consequently adenomyosis is encountered more frequently in the fertility clinic during diagnostic work-up. Furthermore, it is difficult to diagnose adenomyosis before surgery, because there are no pathognomonic signs, symptoms or physical findings. Finally, reference data are very limited.


RESULTS
This review refers to adenomyosis of the uterus as a factor in female infertility. The clinical presentation of adenomyosis uteri is also reviewed, as well as animal and human studies concerning the effect of adenomyosis in female infertility. Different treatment options are discussed, especially those referring to patients who wish to maintain their fecundity.


CONCLUSIONS
Uterine adenomyosis remains a fairly frequent and debilitating disease that will be encountered with increasing incidence in the infertile female population. While spectacular advances have been made in recent years in the non-invasive diagnosis of the condition, non-surgical treatment options for infertile patients with adenomyosis arise but need to be confirmed in larger series.
Matalliotakis
Ioannis M
IM
Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06520-8063, USA. matakgr@yahoo.com
Katsikis
Ilias K
IK
Panidis
Dimitrios K
DK
D000818:Animals; D004621:Embolization, Therapeutic; D004715:Endometriosis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000209:etiology*
D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone