Any woman diagnosed with adenomyosis and planning to have children (or who is already expecting), is worried about how the diagnosis may affect the chances of conception and the process of childbearing. What is adenomyosis and what does it mean for your fertility?
Adenomyosis and Pregnancy: Is There a Cause for Concern?
Adenomyosis is the benign invasion of endometrium into the myometrium, producing an enlarged uterus. In simpler words, the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium) causing significant pelvic pain, lower abdominal pressure, bloating before and during menstrual periods, and often heavy periods.
A common question is “Why does adenomyosis cause thickening of the uterus?” The uterus responds to “external invasion” by the formation of the muscles’ thickening around the “invader”, trying to prevent it from spreading. Through this process, the uterus’ lining increases in size. It is important to note that adenomyosis can be often misdiagnosed as fibroids due to similarities in symptoms and due to the fact that adenomyosis can be difficult to diagnose on pelvic ultrasound. However, fibroids and adenomyosis are entirely different conditions, but fortunately both can be treated with Uterine Artery Embolization (UAE).
Adenomyosis and pregnancy is a matter of concern to many women. Can the condition prevent you from conceiving and giving birth to a healthy baby?
What Difficulties Can Be Expected when Planning a Pregnancy With Adenomyosis?
As evidence shows, a woman can become pregnant with adenomyosis. Sometimes, women who do not even suspect the existence of the condition, get pregnant and give birth without any problems. However, this is usually true only in the beginning stages of adenomyosis. In some cases, adenomyosis is the cause of infertility. The famous actress Gabrielle Union and her husband former NBA star Dwayne Wade struggled for years with infertility not knowing until 2019 that it was due to adenomyosis.
Challenges conceiving: The main problem when trying to conceive a child can be a cycle inconsistency. The menstrual cycle is usually irregular, can be shortened or prolonged. In more complex cases, when the condition affects most of the uterus, adhesions may form. This can become a barrier to sperm as it moves to the egg.
Embryo implantation: In advanced cases of adenomyosis, when most of the uterus is affected, the fertilized egg can struggle finding a place to implant itself.
Childbearing challenges: As in the case of fertilization and implantation of the embryo, childbearing is not a problem when adenomyosis is in the beginning stages. In some cases, women can be prescribed hormone therapy in the first months of pregnancy. In severe cases, the situation is different: due to pathological changes in the uterus there is a threat of miscarriage. Therefore, with more advanced stages of adenomyosis, it is better to plan a pregnancy in advance so that a doctor can prescribe a treatment to minimize the chances of a miscarriage.
Childbirth: Natural childbirth is optimal, if possible. But if the uterus is significantly affected, a C-section is likely. All cases are individual, and only an experienced doctor can determine the best option.
You should know that adenomyosis is not a sentence. While in many cases a hysterectomy is offered to women suffering from adenomyosis, it’s possible to avoid surgery. Uterine Artery Embolization (UAE) is an effective nonsurgical alternative that allows women to keep their uterus and possibly conceive in the future. To learn more about uterine artery embolization and pregnancy with adenomyosis, call Atlanta Fibroid Center at 770-953-2600 or make an appointment online.