Today an accurate diagnosis of adenomyosis can be made thanks to progress in imaging techniques: sonography and magnetic resonance imaging (MRI). This has made it possible to clinically correlate the presence of adenomyosis to infertility. At the same time, a series of pathogenetic hypotheses have been presented to explain this correlation. First, the identification of the myometrial junctional zone (JZ) and of its disruption and thickening has been linked to poor reproductive performance mainly through perturbed uterine peristalsis, a phenomenon that originates exclusively from the JZ in the nonpregnant uterus. In addition, a number of biochemical and functional alterations in both eutopic and heterotopic endometrium in women with adenomyosis have now been found to lead to lower receptivity, indicated by the presence of 'implantation marker' defects. In these patients there is also an altered decidualization and abnormal concentrations of intrauterine free radicals. All these abnormalities in the endometrial environment seem to contribute to subfertility. Several attempts have been made to restore fertility in adenomyosis patients, the oldest being gonadotrophin-releasing hormone agonists coupled to conservative surgery. Also, uterine artery embolization and MRI-assisted high-intensity focused ultrasound ablation have been tried with some degree of success.
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http://dx.doi.org/10.1016/j.rbmo.2011.10.003 | DOI Listing |
Introduction: Early pregnancy care involves the screening and identification of women with risk factors for adverse pregnancy outcomes, including stillbirth or preterm birth, to tailor pregnancy care and interventions accordingly. Most stillbirths and approximately two-thirds of preterm births, however, occur in the absence of evident risk factors. The majority of stillbirths occur in the preterm period, yet there are few interventions targeting this period, and progress to reduce stillbirth rates remains slow.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Key Laboratory of Reproductive Genetics (Ministry of Education) and Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, 310006, Zhejiang, China.
Background: The success of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) in endometriosis patients varies widely, and predicting the likelihood of achieving a live birth remains a clinical challenge. This study aims to develop a predictive nomogram for assessing the cumulative live birth (CLB) rate following IVF/ICSI cycles among patients with endometriosis.
Method: A retrospective cohort study was conducted to analyze the clinical data of 1457 patients with endometriosis after IVF/ICSI treatment from January 2017 to August 2022.
PLoS One
January 2025
Department of Obstetrics and Gynecology, Danderyd Hospital, Stockholm, Sweden.
Introduction: Dysmenorrhea and heavy menstrual bleeding are the most common symptoms in adenomyosis, in addition to infertility and chronic pelvic pain. Hysterectomy is a common treatment for adenomyosis symptoms with curative effect on heavy menstrual bleeding but with less studied effects on pain reduction.
Material And Methods: This is a nationwide retrospective register-based cohort study including all hysterectomized patients with pathology-verified adenomyosis between 1 January 2012 and 31 December 2015 with a long-term follow-up three years pre- and three years postoperatively.
Front Reprod Health
December 2024
Department of Obstetrics and Gynecology, American Hospital, İstanbul, Türkiye.
Endometriosis and adenomyosis are prevalent causes of infertility, often coexisting in a significant proportion of patients. Although endometriosis typically does not negatively impact assisted reproductive technology (ART) outcomes, the presence of coexisting adenomyosis, mainly non-severe external forms, may slightly influence IVF/ICSI success rates. However, this impact is often minimal and may result in insignificant changes in statistical analyses.
View Article and Find Full Text PDFJ Clin Med
December 2024
Laboratory of Tumor and Development Biology, Giga-Cancer, University of Liège, 4000 Liege, Belgium.
Adenomyosis is a benign condition where ectopic endometrial glandular tissue is found within the uterine myometrium. Its impact on women's reproductive outcomes is substantial, primarily due to defective decidualization, impaired endometrial receptivity, and implantation failure. The exact pathogenesis of the disease remains unclear, and the role of autophagy in adenomyosis and its associated infertility is not well understood.
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