Reproductive function in patients with adenomyosis after organ-preserving operations

• Irena F. Kozachenko
• Leyla V. Adamyan

Abstract

Background. Adenomyosis (AM) still remains one of the main problems of modern gynecology, the incidence of external genital endometriosis in AM is 80.6%, isolated AM was observed in only 24% of the examined patients. The frequency of realization of reproductive function is disappointing - Less than 20%, including methods of assisted reproductive technologies.

The aim of this work is to evaluate the reproductive function in patients with adenomyosis after organpreserving treatment

Material and methods. 350 patients of reproductive age with a histologically established and verified diagnosis of "adenomyosis" were examined and surgically treated. The patients were divided into 2 groups. The 1^st group consisted of 150 patients with diffuse AM, the 2^nd group - 200 patients with nodular and diffuse-nodular AM.

Results. In AM patients, surgical treatment in the volume of removal of adenomyosis nodes or excision of the myometrium affected by adenomyosis, followed by hormone therapy, contributed to the implementation of reproductive function in 31% of patients.

Conclusion. Treatment of patients with AM should be determined depending on the clinical manifestations of the disease, the age of patients, their reproductive plans, as well as the presence of a combined pathology. Organ-preserving surgical treatment of AM in combination with conservative therapy (hormonal and physical therapy) is a factor that significantly contributes to an increase in the frequency of pregnancy in ART programs and an increase in the frequency of delivery.

Keywords:adenomyosis, organ-preserving treatment, reproductive function, in vitro fertilization

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