Adenomiosis as a cause of infertility: real or imaginary connection?
AbstractBackground. The etiology of infertility and its relationship to adenomyosis is controversial, and the exact mechanisms of infertility are unclear, since one part of women with endometriosis are capable of spontaneous conception, the second is forced to resort to surgery and/or in vitro fertilization, and the third undergo repeated failures when using assisted reproductive technologies. Unfortunately, infertility tends to be another pandemic in the modern world. Therefore, study of causes of infertility formation is extremely important both from the standpoint of prevention and treatment of topical gynecological diseases. The impact on fertility of such a disease known to every gynecologist as adenomyosis often causes a lot of controversy. Therefore, a review of modern research on this issue seems relevant.
The aim of the study was to consider adenomyosis as a cause of infertility from a controversial position based on the analysis of scientific publications and to describe the potential mechanisms for infertility formation.
Results. Despite some difficulties in studying the relationship between adenomyosis and infertility, according to meta-analyses, its negative impact on fertility has been proven. Four hypothesized mechanisms underlie the formation of infertility in adenomyosis: disorders of endo-myometrial peristalsis, endometrial receptivity, implantation, and association with chronic endometritis.
Conclusion. It is worth recognizing that earlier there was an underdiagnosis of adenomyosis, and therefore an underestimation of its potential impact on fertility. However, modern studies with a high degree of evidence indicate a negative effect of adenomyosis on reproduction. Therefore, the connection between adenomyosis and infertility, which previously seemed imaginary, is now quite real, and it is based on endometrial dysfunction.
Keywords:adenomyosis; infertility
Conflict of interest. The authors declares no conflict of interest.
Funding. The study had no sponsor support.
Contribution. Writing the text – Barinova E.K; text editing – Orazov M.R., Mikhaleva L.M., Khamoshina M.B.; concept and design – Tsaregorodtseva M.V., Besman I.V., Ibragimova V.Yu.
For citation: Orazov M.R., Mikhaleva L.M., Khamoshina M.B., Tsaregorodtseva M.V., Besman I.V., Ibragimova V.Yu., Barinova E.K. Adenomiosis as a cause of infertility: real or imaginary connection? Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2023; 11. Supplement: 132–8. DOI: https://doi.org/10.33029/2303-9698-2023-11-suppl-132-138 (in Russian)
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