Adenomyosis Can Make You Infertile: Here’s How You Can Deal With This Condition

Among the many gynecological conditions, one that has got less spotlight and awareness is Adenomyosis. As per a study published in the Obstetrical and Gynecological Survey, adenomyosis mostly affects women in the age of 40 and 50 who have already had children and approximately 20 per cent of cases occur in women under the age of 40. Adenomyosis is a condition in the uterus that makes it get thicker and can cause pelvic pain and irregular bleeding. It causes the tissue that lines the uterus to grow into the surrounding tissues. Yet not many women are aware of such a condition. Normally the inside of the uterus is lined with endometrial tissue, which is shed by the body during heavy period. In adenomyosis situation, the tissue doesn’t remain inside the uterus. Instead, it grows into the myometrium (wall of the uterus) and results in thickening of the uterus. The tissue continues to respond to the cycles of hormones, even though it is growing in the wrong place. With every menstrual cycle, it thickens, sheds, and bleeds, which can lead to an enlarged uterus and painful, heavy periods.

The condition is similar to endometriosis, which occurs when endometrial tissue grows outside of the uterus. Young women with adenomyosis have higher chances of endometriosis in comparison to women who are above 40 years of age.

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SYMPTOMS OF ADENOMYOSIS

Symptoms of adenomyosis varies from person to person. Some women may experience no symptoms at all while other may have mild discomfort including:

• Painful menstrual cramps (dysmenorrhea)
• Heavy menstrual bleeding (menorrhagia)
• Abnormal menstruation
• Pelvic pain
• Painful intercourse (dyspareunia)
• Infertility
• Enlarged uterus

People who are diagnosed with adenomyosis, their uterus may grow up to two to three times its normal size. This could result in pelvic pressure or tenderness in the lower abdomen.

DIAGNOSING ADENOMYOSIS

It has a persistent and progressive tendency which requires timely diagnosis. It remains a largely clinical diagnosis. Definitive diagnosis requires a histologic exam of uterine tissue by gynecologist in per vaginal examination enlarged and tender uterus. The diagnosis of adenomyosis is made on a pathologic specimen, obtained after hysterectomy

Few methods to diagnose adenomyosis are:

Ultrasonography

Ultrasonography is the first consideration for diagnosis of Adenomyosis given its efficacy, safety, and lower cost. The sonography helps the doctor with visualization of endometrial glands and stroma (supportive tissue of an epithelial organ, tumor, gonad, etc., consisting of connective tissues and blood vessels). In the case of adenomyosis being present, the doctor can ascertain noting the specifics that include uterine enlargement, thickening of uterine walls and a lack of homogeneity within the myometrium, among other.

3D TVS

These are as sensitive specific as MRI.

• Diffusely enlarged, globular, asymmetric uterus
• Distorted, heterogenous myometrium with increased or decreased areas of echogenicity
• Presence of myometrial cysts: poorly defined areas with abnormal echotexture
• Irregular/absent uterine junctional zone
• Myometrial mass with ill-defined borders

MRI

• T2 weighted image: junctional zone thickness greater than 12mm

AVAILABLE TREATMENTS

Adenomyosis can make it harder for patients to get pregnant and can lead to more complications during a pregnancy. Infertility seems to be one of the clinical presentations of adenomyosis. Although an association between this condition and infertility has not been fully established, based on the recent studies it is suggested that adenomyosis has a negative impact on female fertility. It is also suggested that women opting for IVF procedure with adenomyosis have less chances of successful embryo implantation and increased miscarriage rate. Evidence points to the fact that if treated rightly, the infertility caused can be reversed in many cases with natural conception and eventual live birth.