Adenomyosis is when tissue similar to the lining of the uterus (endometrium) starts to grow into the muscle wall of the uterus (myometrium). It causes the uterus to thicken and enlarge — sometimes, up to double or triple its usual size. Doctors are still not sure why it is caused, but it is usually resolved after menopause.
Apart from the times when adenomyosis doesn’t cause any or just mild symptoms, in all the rest cases it causes:
In endometriosis, endometrial-type tissue grows outside the uterus. In adenomyosis, abnormal tissue grows into the uterine muscle. Although they are different conditions they can both cause pelvic pain, unusual menstrual bleeding, and heavy periods.
Because the two conditions share some common symptoms, it can be difficult for doctors to diagnose in time one over the other.
They also don’t know the exact prevalence of either of the two diseases. This is because people with endometriosis for example often do not receive a diagnosis for many years, and surgery is the only way to definitively diagnose it. This means that the actual number of people with may be much higher than current estimates.
Most estimates suggest that 10–15% of reproductive-age women have the condition. Among those with pelvic pain, the prevalence may be as high as 70%.
Similar issues of under-reporting and underdiagnosis exist for adenomyosis too.
Treatment depends on the severity of the symptoms and if the woman has already given birth. Mild symptoms are usually treated with medication.
There are cases of women who have simultaneously adenomyosis and endometriosis. That being said doctors find it difficult to understand how adenomyosis on its own may cause infertility struggles, but studies suggest that it may contribute to infertility.
According to recent studies, adenomyosis negatively affects IVF, pregnancy, and live birth rates, as well as increases the risk of miscarriage. In addition, it enhances the risk of obstetric complications, such as premature birth and preterm rupture of the amniotic membranes.
There is no specific treatment for patients with adenomyosis who want to preserve their fertility. Sometimes, combined treatment can be proposed, such as laparoscopy, GnRH treatment, and IVF.
When comparing pharmacological and surgical treatment, the latter appears to be more effective but some details are unclear, i.e., how long pregnancy should be delayed after treatment and whether hormone treatment after surgery improves fertility outcome. Despite many studies on the pathogenesis of fertility failure in adenomyosis, their results are not correlated with treatment.
Not to be bothered with the scientific terms while reading the article, the most important thing to keep in mind, is the importance of finding the right doctor for you. A doctor who understands your wants and needs and will suggest the right actions. Although adenomyosis – and endometriosis too – may take a long to be diagnosed, that doesn’t mean that there is no hope for those who wish to conceive. Even with the tiniest of symptoms, you should feel comfortable to reach out to your doctor and ask for his/her help.
MEDIPASS cooperates with 8 highly experienced fertility specialists who perform fertility treatments in some top-notch around the country. Having one of them as your doctor would be a privilege, and also having us by your side will surely make your fertility journey less lonely and stressful.
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