Adenomyosis and IVF

How does adenomyosis differ from endometriosis?

Adenomyosis happens when the same kind of cells that line the uterus also grows deep in the muscular wall of the uterus and thickens it
Endometriosis happens when the same type of cells that line the uterus, or womb, also grows outside of it. The growth can breach nearby organs like ovaries, fallopian tubes, and bladder

How does adenomyosis impacts fertility?

The exact mechanism on how adenomyosis impacts fertility is not yet know, below are some possible ways on how adenomyosis impacts fertility
- Abnormal utero-tubal gamete and the embryo transport and disruption of endometrial function and receptivity have been described [1].
- An enlarged uterus, anatomical distortion and intramural adenomyoma may have a negative impact on sperm migration, embryo transfer and implantation potential [1].

What is the prevalence of adenomyosis and infertility?

Adenomyosis affects 20-35% of reproductive age women [2]
Of the women who have a diagnosis of infertility, 50-85% have a diagnosis of adenomyosis [3]
- Limitation: Many women with a diagnosis of adenomyosis also has a diagnosis of endometriosis; therefore, the diagnosis of infertility cannot solely be attributed to adenomyosis alone

Does adenomyosis impact IVF success rate?

Adenomyosis and IVF success rate is a controversial topic, some studies have found that adenomyosis was associated with decrease embryo implantation rate. However, based on the most recent evidence, adenomyosis does not significantly alter IVF success (egg retrieval and embryo transfer) rate when adjusted for confounding factors including maternal age and smoking status. [4]
Since adenomyosis and IVF success rate is a controversial topic, there are still ongoing studies to evaluate the impact of adenomyosis on IVF outcomes and if certain pretreatment protocols would help further improve IVF success rate.
- The purpose of the various different pretreatment protocols is to temporarily stop adenomyosis lesions before the embryo transfer process. In theory, that would increase implantation rate, thus pregnancy rate.
- For more details on pretreatment protocols and current research, please reference IVF/Research Literature under the Provider Section of this site.

Does adenomyosis impact pregnancy outcomes?

Adenomyosis can be associated with poor pregnancy outcomes like spontaneous abortion, preterm birth, and fetal growth restriction. Adenomyosis is also a risk factor for preeclampsia. [5]
All of these outcomes and complications mentioned would categorize adenomyosis pregnancy as a high-risk pregnancy and would warrant consulting with a maternal fetal medicine (MFM) provider to determine if close monitoring by a MFM provider is recommended. [6]