title: Adenomyosis does not affect implantation, but is associated with miscarriage in patients undergoing oocyte donation.
abstract: OBJECTIVE
  To evaluate the effect of adenomyosis on endometrial gene expression and its correlation with clinical outcome.
  
  
  METHODS
  Transcriptomic analysis of the endometrium of women with adenomyosis during the window of implantation. Retrospective matched cohort study of the impact of adenomyosis on oocyte donation (OD) outcome.
  
  
  METHODS
  University-affiliated infertility clinic (2005-2009).
  
  
  METHODS
  Endometrial samples were analyzed using microarrays in women with adenomyosis and healthy controls. The clinical study included three groups: adenomyosis, endometriosis, and control.
  
  
  METHODS
  Endometrial biopsies in natural cycles 7 days after the LH peak; controlled ovarian stimulation in donors; ET in recipients after replacement therapy.
  
  
  METHODS
  Differentially expressed genes; implantation, pregnancy, miscarriage, and term pregnancy rates in OD.
  
  
  RESULTS
  There is a similar endometrial gene expression pattern in both the adenomyosis group and controls, and nonparametric tests revealed 34 dysregulated genes in adenomyosis patients but none belonged to the group of window of implantation genes. Implantation in OD did not differ among the three groups. However, miscarriage was significantly higher in the adenomyosis group vs. the adenomyosis + endometriosis and control groups. Term pregnancy rate was also significantly lower in the adenomyosis group compared with others.
  
  
  CONCLUSIONS
  Clinical and molecular data show that implantation is not affected by adenomyosis, but the higher miscarriage rates associated with this condition lead to lower term pregnancy rates, indicating a clear negative effect on the final outcome of OD.
authors.affiliation: Instituto Valenciano de Infertilidad, Valencia, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Martínez-Conejero
authors.forename: Maika
authors.initials: M
authors.lastname: Morgan
authors.forename: Manel
authors.initials: M
authors.lastname: Montesinos
authors.forename: Sara
authors.initials: S
authors.lastname: Fortuño
authors.forename: Marcos
authors.initials: M
authors.lastname: Meseguer
authors.forename: Carlos
authors.initials: C
authors.lastname: Simón
authors.forename: José A
authors.initials: JA
authors.lastname: Horcajadas
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellicer
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology* / Q000235:genetics / Q000473:pathology*; D000328:Adult; D015331:Cohort Studies; D010064:Embryo Implantation / Q000502:physiology*; D004715:Endometriosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000235:genetics; D005260:Female; D020869:Gene Expression Profiling / Q000379:methods; D006801:Humans; D018587:Oocyte Donation / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate / Q000639:trends; D012189:Retrospective Studies; D014463:Ultrasonography