Adenomyosis & Infertility

Although adenomyosis has been largely linked to infertility, nowadays there are therapeutic protocols that can create in the uterus an ideal environment for the implantation of the embryo. Thus, the cases where adenomyosis can impair implantation of an embryo either by in vitro fertilization or natural conception have significantly decreased.

Understanding adenomyosis

Adenomyosis is a benign condition of the uterus and occurs when there is an expansion of endometrial tissue (the tissue that covers the inner surface of the uterus) into the muscular wall of the uterus (myometrium). This condition causes uterine enlargement, abnormal bleeding, dysmenorrhea, chronic pelvic pain and infertility.

Although its causes have not been precisely determined, it seems to occur more frequently in women over the age of 35. In addition to age, surgery to the uterus or previous births may contribute to its appearance. In some studies, hormonal disorders can lead to the appearance of adenomyosis and they involve hormones such as estrogen, progesterone, prolactin and follicle-stimulating hormone. Several times adenomyosis coexists with endometriosis, although it is a disease with the exact opposite characteristics.

Adenomyosis and in vitro fertilization: How does adenomyosis prevent implantation?

Adenomyosis negatively affects the outcome of embryo implantation and leads to reduced rates of successful pregnancy outcome by increasing miscarriage rates. It causes hormonal disorders, which in turn affect ovulation, fertilization and subsequently the development of the fetus. Moreover, there are not a few cases where, although the implantation is successful, the embryo does not develop normally, due to the abnormal environment inside the uterus.

In addition, according to some recent research, adenomyosis contributes to the reduction of the ovarian reserve. This situation makes it more difficult for assisted reproduction treatments to be successful as can impact the number and quality og eggs collected. Therefore, adenomyosis is a condition that makes it difficult to successfully conceive naturally and/or with IVF.

Adenomyosis and IVF: What problems does it cause to the IVF process?

Adenomyosis can be one of the leading causes of IVF failure and requires special management to achieve pregnancy. IVF is a complex process with many steps and adenomyosis can affect the response of the ovaries to stimulation drugs and make the egg retrieval process difficult, while it can also lead to failed embryo implantation due to the inappropriate environment inside the uterus. This results in many times not retrieving the optimal number of eggs from the uterus and requiring individualized treatment protocols depending on the extent of adenomyosis.

Ways to deal with the problems caused by adenomyosis in fertility

Adenomyosis is a great challenge for gynecologists because it causes serious dysfunctions in the uterus. However, nowadays its negative consequences can be treated, reducing the chances of failed embryo implantation.

A key factor for the success of IVF is the expertise of the physician and the proper preparation of the patient. Depending on the extent of the adenomyosis and the patient’s profile, the treatment can be pharmaceutical and/or surgical.

Adenomyosis appears to be more common than previously believed by the medical community. Don’t ignore changes in your menstrual cycle that may be symptoms of a medical condition. Its timely diagnosis is of paramount importance for its treatment and the achievement of pregnancy.

If you are facing fertility problems, contact the experienced and specialized Obstetrician-Gynecologist Melina Stasinou. Dealing with infertility is a special “fight” and the physician designs each time a unique and personalized treatment plan based on the patient’s needs and underlying pathology. Contact us to book your appointment.