Adenomyosis and infertility

Louis, Louay; Saso, Srdjan; Chatterjee, Jayanta; Barsoum, E.; Al-Samarrai, M.

doi:10.1016/j.rbmo.2012.02.013

Cited by 12 publications

(12 citation statements)

References 4 publications

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“…[21] However, adenomyosis typically involves the myometrium in an irregular and massive way, characterized by lesions with unclear borders, so much so that complete excision of adenomyotic tissue is not possible, with obligate loss of healthy myometrium, [22] it is plausible that residual small lesions may continue to grow and relapse. [23,24] Wang et al [25] compared and analyzed the recurrence rate of patients with symptomatic adenomyoma after surgical–medical treatment and surgery alone, relapse were 28.1% and 49%, respectively. [25] Compared with old classical reduction surgery, Fujishita's innovative H incision technique may be considered a useful method for an easy surgical approach and satisfactory removal of adenomyotic lesions, the major complication or pregnancy or subjective relief of pain may be better.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy of adenomyomectomy using “H” type incision combined with Mirena in the treatment of adenomyosis

et al. 2019

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To evaluate the clinical efficacy and safety of adenomyomectomy using “H” type incision combined with Mirena (LNG-IUS) in the treatment of adenomyosis.A total of 57 women with adenomyosis who underwent adenomyomectomy using “H” type incision combined with LNG-IUS were selected. Visual analog scale (VAS), menstrual flow, uterine volume, serum CA125 levels and hemoglobin amounts were compared before and after the surgery. Meanwhile, postoperative pregnancy, adverse reactions, and recurrence were observed.VAS score, menstrual flow, uterine volume, and serum CA125 levels in 53 patients were significantly reduced after surgery (P < . 001). Moreover, statistical significances were obtained for VAS score at 13 and 6 months, menstrual flow at 1, 3, 6, 12, and 24 months, uterine volume at 1, 3, 6, 12, 24, and 36 months and CA125 levels at 1 and 3 months (P < .05). Of the 5 patients with fertility requirements, 1 became pregnant after IVF-ET, progressed to preterm, and delivered healthy twins. Among all related adverse reactions, amenorrhea was the most common (n = 20, 37.7%). There were no cases of LNG-IUS removal, ectopia, expulsion, and incarceration, except in 2 patients due to pregnancy, 1 due to uterine bleeding, and 1 due to Mirena perforation from incision of the uterine fundus. All patients showed no relapse.Adenomyomectomy using “H” type incision combined with Mirena constitutes a novel and effective conservative surgical procedure for adenomyosis treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy of adenomyomectomy using “H” type incision combined with Mirena in the treatment of adenomyosis

et al. 2019

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“…Adenomyosis is diagnosed in 10 to 66% of women at the time of hysterectomy 3 . It is systematically associated with menorrhagia, dysmenorrhea, chronic pelvic pain and dyspareunia 4,5 , and can interfere with embryo implantation and cause subfertility 6,7 . Currently, adenomyosis is more frequently diagnosed in infertile patients by transvaginal ultrasonography and magnetic resonance imaging 8 .…”

Section: Introductionmentioning

confidence: 99%

β-catenin activates TGF-β-induced epithelial–mesenchymal transition in adenomyosis

Yoo

Kim

et al. 2020

Exp Mol Med

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Adenomyosis is defined as the presence of ectopic nests of endometrial glands and stroma within the myometrium. Adenomyosis is a common cause of dysmenorrhea, menorrhagia, and chronic pelvic pain but is often underdiagnosed. Despite its prevalence and severity of symptoms, its pathogenesis and etiology are poorly understood. Our previous study showed that aberrant activation of β-catenin results in adenomyosis through epithelial–mesenchymal transition. Using transcriptomic and ChIP-seq analysis, we identified activation of TGF-β signaling in the uteri of mutant mice that expressed dominant stabilized β-catenin in the uterus. There was a strong positive correlation between β-catenin and TGF-β2 proteins in women with adenomyosis. Furthermore, treatment with pirfenidone, a TGF-β inhibitor, increased E-cadherin expression and reduced cell invasiveness in Ishikawa cells with nuclear β-catenin. Our results suggest that β-catenin activates TGF-β-induced epithelial–mesenchymal transition in adenomyosis. This finding describes the molecular pathogenesis of adenomyosis and the use of TGF-β as a potential therapeutic target for adenomyosis.

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“…The mean ablation rate reported ranged from 50% to 76% [4][5][6][17][18][19][20]. It is plausible that residual lesions may continue to grow and relapse [21][22]. The LNG-IUS is suitable for maintenance therapy because it directly delivers 20 mg/days of an levonorgestrel into the uterine cavity for longer than 5 years.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided transvaginal radiofrequency ablation combined with levonorgestrel-releasing intrauterine system for symptomatic uterine adenomyosis treatment

Nie

Hou

Guo

2021

International Journal of Hyperthermia

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Objective: To evaluate the clinical outcomes of transvaginal ultrasound-guided radiofrequency ablation (RFA) combined with a levonorgestrel-releasing intrauterine system (LNG-IUS) for the treatment of symptomatic uterine adenomyosis. Methods: Patients with symptomatic uterine adenomyosis treated with ultrasound-guided RFA in combined with an LNG-IUS from January 2013 to January 2016 and followed up for 3 years after treatment were selected. Assessment endpoints included the uterine volume reduction rate, dysmenorrheal score, symptom severity score and adverse events. Results: Among the 72 patients, 64 completed the 3-year follow-up evaluations after treatment. No LNG-IUS expulsion was reported. Dysmenorrhea and symptom severity scores statistically significantly declined after the combined treatment of RFA and LNG-IUS was administered. The uterine volume significantly decreased, and the average reduction rate was 55%. Conclusion: Ultrasound-guided RFA combined with an LNG-IUS might be a simple, safe and effective alternative for the treatment of symptomatic adenomyosis.

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Adenomyosis and infertility

Cited by 12 publications

References 4 publications

Clinical efficacy of adenomyomectomy using “H” type incision combined with Mirena in the treatment of adenomyosis

Clinical efficacy of adenomyomectomy using “H” type incision combined with Mirena in the treatment of adenomyosis

β-catenin activates TGF-β-induced epithelial–mesenchymal transition in adenomyosis

Ultrasound-guided transvaginal radiofrequency ablation combined with levonorgestrel-releasing intrauterine system for symptomatic uterine adenomyosis treatment

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