What Is Adenomyosis And How It Affects Fertility

Adenomyosis is a common uterine condition, and  20-25 % of women suffer from it. Experts debate that adenomyosis is a type of endometriosis called “endometriosis cousin”. Therefore, adenomyosis is also defined as: “endometriosis inside uterine muscles”.

Like endometriosis, adenomyosis also affects fertility. But let's first learn more about adenomyosis and adenomyosis symptoms.

What is Adenomyosis?

Adenomyosis is a uterine condition when the tissues in the endometrial lining grow beneath the uterine muscular wall, thickening it and forming endometrium islands in them. It causes swelling and enlargement of the uterus and decreases the cavity or space within it.

The clusters of muscular fibres caused by adenomyosis function like the endometrium and thus respond and rupture as the endometrium does in periods. Occasionally these inner growths can form tumors that need surgery for removal.

Symptoms of Adenomyosis

• Heavy bleeding
• Sharp knife-stabbing-like pain
• Cramping 
• Chronic pelvic pain
• Painful intercourse

What causes them?

Though the exact causes of adenomyosis are still debated, the following conditions increase the risk of having adenomyosis.

• Caesarian delivery
• Surgery in pelvis leaving scar tissue
• Previous uterus surgery
• Hormonal fluctuations or overstimulation of ovaries and endometrial lining
• Fertility medications
• Herediatary

How do Adenomyosis affect fertility?

Earlier studies could not find any clear association between adenomyosis and infertility. But with growing research on fertility and fertility diagnostic tools, the research suggests that adenomyosis does affect fertility and pregnancy in the following ways:

•  It interferes with the conception process, both natural and assisted reproduction via IVF.
• It reduces uterine cavities and draws nutrition used in adenomyosis tissue growth. Hence adenomyosis' presence in pregnancy threatens gestation.
• It imposes miscarriage risk and life risk on the to-be mother.
• It affects the IVF process. Adenomyosis is likely to advance with preliminary hormone stimulation medication that adds odds to the treatment’s success.

A recent analysis of data on adenomyosis in women concludes that women with adenomyosis undergoing IVF treatment have reduced chances of implantation, clinical pregnancy and live births chances. Also, the risk of miscarriage is higher.

Although adenomyosis's contribution to infertility is still a research topic, based on case-studies adenomyosis lowers endometrial receptivity for implantation, alters estrogen or progesterone receptivity functioning, and causes inflammatory responses in the uterus as well the pelvic region.

Diagnosis of Adenomyosis

Adenomyosis is most commonly diagnosed during a routine pelvic examination or in women complaining of excruciating pain, cramping, and heavy bleeding in periods. On suspecting symptoms of adenomyosis, the doctors suggest the following diagnostic test for identification of adenomyosis.

• Pelvic examination: The doctor suspects and recognizes uterine swelling in the pelvic examination.
• Transvaginal ultrasound: The doctor does a transvaginal ultrasound to inspect the thickening of  the endometrium with ultrasound waves. 
• MRI: MRI scan shows clear images of thickening of the uterine wall and enlargement of the uterus. It also gives a detailed view of the number and size of adenoma presence with color-contrast images.
• Biopsy: Biopsy is usually indicated when the doctor suspects sarcoma or tumor, or extreme adenomyosis. The doctor may recommend a hysterectomy, i.e., complete or partial removal of the uterus.

Treatment of Adenomyosis

The treatment depends on the extent of adenomyosis, your wish to preserve fertility, and most importantly, the health condition that adenomyosis may affect.

Your treatment may include anti-inflammatory medications in primary adenoma stages. Doctors can prescribe IUD usage, which is reversible, and 70% of patients have lodged satisfaction with its usage. But if medications or other treatments are ineffective, the doctor may indicate selective surgical removal of adenomyosis tissues. Also, the doctor will indicate hysterectomy If 

• There are several tissue clusters in adenomyosis
• They cause severe pelvic inflammatory disease
• You don’t wish to preserve fertility anymore
• Or, the doctor suspects cancerous cells presence

Spontaneous pregnancy with adenomyosis can be risky and lead to premature delivery, complicated gestation, and life risk to both baby and to-be mother. Hence it is advisable to get your screening tests before planning pregnancy and consult an IVF expert if you already have adenomyosis. Our experts at MMC IVF are highly experienced in dealing with adenomyosis, endometriosis, obstetrics and assistive reproduction.

Reach out to our experts now!