Impact of adenomyosis on fertility and the choice of management / 中国实用妇科与产科杂志

ABSTRACT

Adenomyosis has high prevalence in infertility women,deteriorating the pregnancy results of in vitro fertilization therapy for couples with or without pelvic endometriosis.The mechanisms of effect includeanatomical distortion,uterine dysperistalsis,altered implantation environment,intrauterine free radicals excess and overactive immune system,etc.Assisted reproductive technology is an effective measure to improve the pregnancy outcome,and conservative surgery adds up some natural conception while alleviating the symptoms.Obstetric complications should be taken into account before cytoreductive surgery.Gonadotropin releasing hormone agonist is usually combined with other therapies.Robust evidence is needed for the reproductive effect and safety of high intensity focused ultrasound ablation.