Adenomyosis in endometriosis—prevalence and impact on fertility. Evidence from magnetic resonance imaging

TLDR

The study tests the hypothesis that adenomyosis is strongly associated with endometriosis and contributes to infertility in affected women. Uterine magnetic resonance imaging was performed on 160 women with endometriosis and 67 without. The posterior junctional zone was significantly thicker in women with endometriosis, correlated positively with disease stage and age, and was thicker in those with fertile partners; adenomyosis was present in 79 % of all endometriosis cases and 90 % of women under 36 with fertile partners, indicating a strong association with infertility likely by impairing uterine sperm transport. METHODS.

Abstract

The hypothesis is tested that there is a strong association between endometriosis and adenomyosis and that adenomyosis plays a role in causing infertility in women with endometriosis. METHODS. Magnetic resonance imaging of the uteri was performed in 160 women with and 67 women without endometriosis. The findings were correlated with the stage of the disease, the age of the women and the sperm count parameters of the respective partners.The posterior junctional zone (PJZ) was significantly thicker in women with endometriosis than in those without the disease (P<0.001). There was a positive correlation of the diameter of the PJZ with the stage of the disease and the age of the patients. The PJZ was thicker in patients with endometriosis with fertile than in patients with subfertile partners. The prevalence of adenomyotic lesions in all 160 women with endometriosis was 79%. In women with endometriosis below an age of 36 years and fertile partners, the prevalence of adenomyosis was 90% (P<0.01)With a prevalence of up to 90%, uterine adenomyosis is significantly associated with pelvic endometriosis and constitutes an important factor of sterility in endometriosis presumably by impairing uterine sperm transport.