Hardware visualization of adenomyosis and the reproductive outcomes of surgical treatment for adenomyosis-associated infertility


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Abstract

The presented review includes an analysis of clinical trials evaluating the impact of adenomyosis on reproductive function, as well as a review of studies on the relationship between surgical treatment options for adenomyosis and reproductive outcomes. Studies of female populations after in vitro fertilization and/or intracytoplasmic sperm injection (IVF/ICSI) and after surgical treatment for deep adenomyosis have shown that adenomyosis has a negative impact on a reproductive outcome in both cases, although there are substantial differences in these populations. The literature contains relatively little data on the degree of influence of the extent of the lesion on reproductive function; however, a significant correlation has been found between them. The positive impact of treatment with gonadotropin-releasing hormone agonists, followed by surgery for adenomyosis, is also described in several sources of literature; however, no controlled trials have been conducted on this topic. Many studies do not meet the significance tests due to the lack of clear inclusion and exclusion criteria in the trial. It is difficult to choose optimal treatment options for adenomyosis based on actual data because there is no significant evidence for the relationship between fertility and the degree of adenomyosis. However, it is known that adenomyosis can reduce the chance of successful implantation so much that it will be reasonable to recommend surgical or other medical options. At the same time, it is necessary to evaluate the possible positive impact of the medical options available in the physician’s arsenal. Thus, timely referral to specialized healthcare facilities for the treatment of adenomyosis may be crucial for the successful implementation of reproductive function in patients with suspected or diagnosed adenomyosis concurrent with recurrent miscarriage, who refuse to use assisted reproductive technologies. Conclusion. This review analyzes the relationship between infertility and adenomyosis and considers studies of reproductive outcomes after different surgical treatment options for adenomyosis in infertile patients.

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About the authors

Kirill Yu. Krylov

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care

Email: drkrylov@mail.ru
Ph.D., obstetrician-gynecologist, Senior Researcher at the Department of Gynecology

Nikolai N. Rukhlyada

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Email: nickolasr@mail.ru
Dr. Med. Sci., Professor, Head of the Department of Obstetrics and Gynecology

Elena I. Biryukova

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care

Email: 79112252131@yandex.ru
Ph.D., Head of the Department of Gynecology No. 2

Leila Sh. Tsechoeva

I.I. Dzhanelidze Saint Petersburg Research Institute of Emergence Care

Email: doctor-leila@mail.ru
Ph.D., Head of the Department of Gynecology No. 1

Simona V. Vinnikova

Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Email: vinnikova@yandex.ru
postgraduate student of the Department of Obstetrics and Gynecology

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