Learn about the connection between adenomyosis and infertility, and how it may impact your fertility journey. Find out more.
Introduction
Adenomyosis is a condition that affects the uterus and is often linked to painful periods, heavy bleeding, and other symptoms that interfere with daily life. But beyond the discomfort, many are unaware of its connection to fertility issues. If you’re facing difficulties conceiving, adenomyosis could be playing a role.
A majority of adenomyosis cases are reported in women in the fourth and fifth decades of life, while 5–25% of cases can occur in women <39 years. In this article, we’ll explain how adenomyosis and infertility are related, what you should know about the condition, and how it can impact your fertility treatment journey. Understanding this connection may help you take the right steps toward parenthood.
Adenomyosis: A Quick Overview
Adenomyosis occurs when the inner lining of the uterus (endometrium) breaks through the muscle wall of the uterus (myometrium). This can lead to various symptoms, including intense menstrual cramps, heavy bleeding, and discomfort during intercourse. It’s often confused with endometriosis, but while the two conditions have similarities, they affect different parts of the reproductive system. Adenomyosis may seem like a condition related only to painful periods, but it has deeper implications for fertility.
How Adenomyosis Affects Fertility
The exact way adenomyosis impacts fertility isn’t fully understood, but there are some theories and research that provide clarity. The changes in the structure of the uterus, disturbed uterine peristalsis and sperm transport can make it more difficult for an embryo to implant successfully, potentially causing early miscarriages or implantation failure. Additionally, the chronic inflammation in the uterus caused by adenomyosis can interfere with the hormone pathways and reduced expression of implantation genes needed for conception. According to a study published, women with adenomyosis who underwent IVF had lower implantation and pregnancy rates compared to women without the condition.
Treatment Options for Fertility with Adenomyosis
If you’ve been diagnosed with adenomyosis and are struggling with infertility, the good news is that there are options available to you. Hormonal treatments, like GnRH agonists, can sometimes help shrink adenomyosis lesions and improve fertility outcomes. The long-term preparation of the endometrium with GnRH-a therapy for 2 to 4 months, before frozen embryo transfer is associated with significantly higher clinical pregnancy, implantation, and ongoing pregnancy rates.
In more severe cases, surgical intervention to remove the affected tissue may be recommended. Fertility treatments such as IVF can also bypass some of the hurdles caused by adenomyosis, although success rates may vary. It’s important to work with a fertility specialist who understands the unique challenges adenomyosis poses, so together, we can develop a plan that works for you.
Conclusion
While other fertility issues often overshadow adenomyosis, its connection to infertility is significant. If you’re dealing with painful periods or heavy bleeding and are struggling to conceive, it might be time to discuss adenomyosis with your doctor. By diagnosing and treating this condition, you may be able to improve your chances of a successful pregnancy. If you suspect adenomyosis might be affecting your fertility, don’t hesitate to reach out to us. We’re ready to support you with the care and treatment options tailored to your needs.
FAQs:
- What is the main difference between adenomyosis and endometriosis?
Adenomyosis affects the inner walls of the uterus, while endometriosis occurs when tissue similar to the uterine lining grows outside the uterus. Both conditions can impact fertility but in different ways.
- Can I still get pregnant with adenomyosis?
Yes, it is possible to conceive with adenomyosis, though it may take longer, and fertility treatments like IVF may be necessary. Working with a specialist can help improve your chances.
- Can adenomyosis be cured?
There is no permanent cure for adenomyosis, but treatments such as hormonal therapy or surgery can manage symptoms and improve fertility outcomes.
- How is adenomyosis diagnosed?
Adenomyosis can be diagnosed through imaging tests like an MRI or ultrasound. Sometimes, it’s identified during fertility evaluations when other causes of infertility are ruled out.
Ref: Pados G, Gordts S, Sorrentino F, Nisolle M, Nappi L, Daniilidis A. Adenomyosis and Infertility: A Literature Review. Medicina (Kaunas). 2023 Aug 26;59(9):1551
