Comparison of Clinical and Reproductive Outcomes between Adenomyomectomy and Myomectomy

Abstract

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Different subtypes of ultrasound‐diagnosed adenomyosis and in vitro fertilization outcomes: A systematic review and meta‐analysis

“…We agree with other groups that adenomyosis should be part of the differential diagnosis in patients with infertility at the first consultation. While there may be benefits from surgical treatment of adenomyosis before IVF, resection may be incomplete in case of lack of capsule, and the risk of uterine rupture during pregnancy may be higher 26 . Therefore, surgery may not be recommended for patients with infertility without symptoms.…”

“…While there may be benefits from surgical treatment of adenomyosis before IVF, resection may be incomplete in case of lack of capsule, and the risk of uterine rupture during pregnancy may be higher. 26 Therefore, surgery may not be recommended for patients with infertility without symptoms. Furthermore, several studies demonstrated no difference in pregnancy outcomes between women with and those without US‐diagnosed adenomyosis undergoing long‐term downregulation ovarian stimulation.…”

“…be higher. 26 Therefore, surgery may not be recommended for patients with infertility without symptoms. Furthermore, several studies demonstrated no difference in pregnancy outcomes between women with and those without US-diagnosed adenomyosis undergoing long-term downregulation ovarian stimulation.…”

Adenomyosis and fertility: does adenomyosis impact fertility and does treatment improve outcomes

“…These positive findings were echoed in a retrospective cohort comparing patients who underwent adenomyomectomy vs. myomectomy via laparoscopic or open approach, with a live birth rate of 46 vs. 71%, P = 0.076 [46]. In patients whose endometrial cavity was entered intra-operatively, hysteroscopy 3 months later revealed 35% with stage I intrauterine synechiae, treated with adhesiolysis [46]. A retrospective series of all 22 pregnancies after adenomyomectomy performed by a single surgeon from 2011 to 2019 found four placental abnormalities, one case of uterine rupture, and no hysterectomies [47].…”

“…A recent systematic review suggested that pregnancy is likely safe after excisional procedures with low rates of uterine rupture (1/126, 0.8%) and a delivery rate of 81% [44]. These positive findings were echoed in a retrospective cohort comparing patients who underwent adenomyomectomy vs. myomectomy via laparoscopic or open approach, with a live birth rate of 46 vs. 71%, P = 0.076 [46]. In patients whose endometrial cavity was entered intra-operatively, hysteroscopy 3 months later revealed 35% with stage I intrauterine synechiae, treated with adhesiolysis [46].…”