Adenomyosis - IVF | ICU | ICSI | OI/TI

Adenomyosis is a benign uterine disorder characterized by the presence of heterotopic endometrial glands and stroma in the myometrium and reactive fibrosis of the surrounding smooth muscle cells of the myometrium. It usually affects patients aged 35 to 50, and symptoms include menorrhagia, dysmenorrhea, and metrorrhagia.

In addition to diffuse, haphazard distributions, adenomyosis can also appear as a mass known as an adenomyoma. As a result, women with this condition have enlarged, boggy uteruses.

In patients with adenomyosis, uterotubal transport is impaired, potentially blocking sperm migration and embryo transport. In addition to abnormal contraction waves in the myometrium, uterine hyperperistalsis can adversely affect sperm passage through the uterus and may also lead to increased intrauterine pressure.

In women, endometrial receptivity and function become altered via increased production of estrogens. These women also experience an elevated inflammatory response. Patients with severe adenomyosis in whom implantation failed were found to have a higher density of macrophages. A higher macrophage density triggers increased intrauterine inflammation and releases reactive oxygen species, which are said to be harmful to embryos.

Finally, implantation is impaired because adhesion molecules are insufficient, implantation markers are reduced, and embryonic development genes are altered.

Contact your reproductive medicine specialist to know more about diagnosis and management options.