Adenomyosis and Fertility: What to Expect

Today an accurate diagnosis of adenomyosis is possible thanks to progress in imaging techniques like MRI. This also made it possible to correlate the presence of adenomyosis to infertility.

What seems clear is that structural and functional defects of the uterine junctional zone play an important role in implantation failure or infertility.

It means that patients diagnosed with adenomyosis can have lower chances of getting pregnant.

Adenomyosis and Fertility: Can I Become A Mom?

Adenomyosis is a pathology characterized by the fact that cells structurally and functionally similar to cells of the uterine mucosa (endometrium) are found in its muscle layer (myometrium).

In connection with the consequences of the disease, as well as with an unwanted pregnancy with any gynecological problem, the question arises whether it is possible to become a mom with adenomyosis.

Sometimes the disease proceeds without consequences for conception for a while. But many factors must be taken into account, if a woman wants to become pregnant, and the uncontrolled course of the disease brings great additional risks.

Why can’t a woman get pregnant with adenomyosis? Because at some of the stages of the disease, which are not exactly the same in every woman, a fertilized egg cannot attach to the uterine wall. Adenomyosis and fertility are becoming a complex issue.

However, even if a woman managed to get pregnant, this is not a complete victory. Adenomyosis is often a risk factor for miscarriage, that is, carrying out a child with adenomyosis is much more difficult.

The causes of a miscarriage can be a violation of the hormonal background, a strong contractile activity of the myometrium, which was damaged due to adenomyosis.

In the initial forms, adenomyosis rarely becomes a problem for bearing a child.

At first, doctors prescribe hormone therapy for safety reasons. But in a severe case of the disease, the uterus already has strong pathological changes, so it can be in good shape. And because of this, the risk of miscarriage is greatly increased.

Therefore, women are told that they need to spend more time in the hospital, as they must constantly be under the supervision of a doctor.

Of course, doctors are trying to maintain a pregnancy, because if you interrupt it, then adenomyosis can develop into an even milder stage. It happens that during childbirth, adenomyosis quenches, at least its symptoms, but they resume with menstruation after childbirth.

Doctors advise to conduct therapy in advance to avoid relapse, which includes hormonal drugs, special medications to improve immunity and other measures.

The way a baby is born usually depends on how much the disease has developed and what form it has. The best option, taking into account all factors, is selected by the doctor.

Most Popular Questions About Adenomyosis and Fertility

Can adenomyosis affect fertility?

Since many women with adenomyosis also have endometriosis, it is difficult to say exactly what role adenomyosis can play in fertility problems. However, some studies have shown that adenomyosis alone can contribute to infertility.

Can adenomyosis cause pregnancy complications?

Any difficulties for pregnancy are most likely associated with problems with the uterus. And women with adenomyosis have a double risk of miscarriage.

Also, chronic inflammation and high intrauterine pressure with adenomyosis can be risk factors for premature birth.

Is pregnancy painful with adenomyosis?

Yes. Pain is one of the adenomyosis symptoms. And in some cases, during pregnancy, the pain syndrome may intensify.

Can I Get Treatment for Adenomyosis and Preserve Fertility?

In severe forms of adenomyosis, if a woman wants to have a baby, the doctor may recommend surrogacy, when the embryo obtained as a result of IVF (in vitro fertilization) is transplanted into the uterine cavity of the surrogate mother, who carries it.

But, of course, timely diagnosis and qualified treatment usually provide an opportunity to restore natural fertility.

One of adenomyosis treatment options is hysterectomy, surgery to remove the uterus. Of course, it is not an acceptable option for women who want to preserve their fertility.

But there is hope!

The second effective option is a nonsurgical procedure called uterine artery embolization or UAE. Uterine artery embolization is essentially the same procedure as uterine fibroid embolization that is performed to treat uterine fibroids.

If you are not familiar with the concept, Dr. John C. Lipman of Atlanta Fibroid Center explains how it works in the video below.

What to Expect from a Pregnancy after UAE

Although adenomyosis is associated with lower fertility rates in general, Dr. Lipman has seen a number of adenomyosis patients getting pregnant after UAE.

It goes without saying that a procedure like UAE must be performed by a very experienced interventional radiologist who regularly performs it with a high rate of success. It’s also very important that you are monitored by the doctor performing the procedure afterwards, i.e. a follow up appointment will be required.

Adenomyosis patients can expect higher incidents of pre-term labor and other high-risk obstetrics, and your OB/GYN will follow you more closely, but the vast majority of patients have successful pregnancies with no issues at all.

If you have been diagnosed with adenomyosis and want to find out more about uterine artery embolization procedure, make an appointment with Dr. John Lipman by calling Atlanta Fibroid Center at 770-953-2600.


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