Adenomyosis is a medical condition common in women and girls. Its causes remain largely unclear, as does its relationship with fertility. The article will help you understand the medical condition and its connection to infertility.
The condition results in heavy periods and extreme menstrual pain, same as endometriosis. Endometriosis and adenomyosis can occur simultaneously, and scientists wonder whether the latter is just one unique form of endometriosis. Currently, the definition of adenomyosis is “endometriosis within the uterine muscle.”
What Causes Adenomyosis?
The disorder’s cause remains unclear, although numerous risk factors are linked to it, including past medical or surgical procedures, such as caesarean deliveries and pregnancy termination. These procedures may distort the uterus lining, causing the abnormality. Other causes include obesity and irregular menstrual cycles.
Because there are no clear approaches to diagnosing the condition, the disease incidence among women and girls varies significantly, between five and seventy percent. In the past, a diagnosis would be made by assessing a specimen doctors collect during surgery to remove the uterus.
However, today, office diagnosis has become possible thanks to ultrasound technology. Gynecologists can easily identify symptoms associated with the condition on ultrasound images. Although MRI may seem more accurate than ultrasound, the latter is more available and affordable.
Does Adenomyosis Affect Fertility?
Various medical research reports connect fertility to the condition. Damage of the uterus cavity can affect fertility because it may block tubal ostia, preventing sperm and embryo transport. An irregular or thickened uterus can also be an indicator of the condition. It impairs implantation by obstructing contractions, which are crucial to the transport of sperm and eggs. A highly concentrated uterus can heighten intrauterine pressure and affect contractions.
Does Adenomyosis Affect IVF?
The disorder can interfere with the in-vitro fertilization (IVF) process. Studies report that the thickening of the junction zone can cause thickening of the inner section of the uterine wall. It is this thickening that leads to implantation failure. The condition affects implantation by altering the expression of molecules that control endometrial receptivity. It causes abnormal expression of these molecules. Furthermore, factors that influence embryo growth tend to be lower in women and girls with this condition. The disease also affects IVF results and may alter pregnancy, miscarriage and successful birth rates. Screening and counseling are necessary before conducting IVF.
Possible Treatment Options for Adenomyosis
Treatment should focus on eliminating all risks linked to embryo abnormality. These risks include maternal age and adverse effects resulting from the condition, such as premature birth, obstruction of uterine growth, miscarriage and bleeding.
Treatment can be through surgical or medical therapies based on the severity of the medical condition. The doctor can recommend anti-inflammatory drugs to slow blood flow, control bleeding and relieve pain.
Hormonal intrauterine device (IUD) insertion is currently the most used treatment. The treatment is reversible and has a great satisfaction rate. If the method fails, you may opt for partial or complete removal of the uterus, which would lead to loss of fertility. In this case, doctors would remove the uterus and prevent the disease from recurring while stopping continuous bleeding.
If you happen to have this condition and would prefer an option that doesn’t affect your fertility, it would be best to talk to a specialist about how to go about it. You may require treatment that supports spontaneous pregnancy, or the doctor may advise you to consider IVF. During pregnancy, women with this medical condition are prone to placental problems and premature delivery, which calls for close monitoring. However, the doctor must select the most appropriate diagnostic tool to confirm the severity of the disease and the best way to handle it.