Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist: Long-term follow-up in a series of nine patients

Huang, Ben-Shian; Seow, Kok-Min; Tsui, Kuan‐Hao; Huang, Chen‐Yu; Lu, Yen-Feng; Wang, Peng-Hui

doi:10.1016/j.tjog.2012.04.008

Cited by 55 publications

(33 citation statements)

References 37 publications

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“…The present results showed that all of the study patients exhibited a significant reduction in pain symptoms, menorrhagia, serum CA125 levels and uterine size after surgery. Dysmenorrhea and menorrhagia are the characteristic symptoms of adenomyosis, and directly related to the surgical efficacy of laparoscopic adenomyomectomy [ 9 , 28 , 29 ]. Serum CA125 levels are considered as a good biomarker to diagnose and monitor the therapeutic efficacy and recurrence of adenomyosis [ 30 , 31 ].…”

Section: Discussionmentioning

confidence: 99%

“…Adenomyosis is a benign gynecologic disorder characterized by the invasion of endometrial glands and stroma in the uterine myometrium, resulting in dysmenorrhea, hypermenorrhea, and infertility [ 1 ]. Although adenomyosis may be treated with several methods, such as hysterectomy, conservative surgery, drug therapy such as gonadotropin-releasing hormone agonist therapy (GnRHa), and uterine artery embolization, complete hysterectomy can thoroughly treat this disease [ 2 - 9 ]. However, total hysterectomy is not suitable for women with adenomyosis who want to preserve their uteri and/or require fertility in the future.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis

Huang

Chen

et al. 2015

BMC Women's Health

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BackgroundAdenomyomectomy has recently been considered the priority option for the treatment of adenomyosis, however, the surgical efficacy and modes are still debated. We aimed to evaluate the efficacy of laparoscopic adenomyomectomy using a double-flap method for the treatment of uterine diffuse adenomyosis when compared with conventional laparoscopic adenomyomectomy.MethodsLaparoscopic adenomyomectomy using the conventional method (group A, n = 48) and the double-flap method (group B, n = 46) to treat diffuse uterine adenomyosis, respectively. Visual analog scale (VAS), menstrual amount, serum CA125 levels, and uterine volume were comparatively analyzed in both groups.ResultsThe VAS scores, menstrual amount, serum CA125 levels, and uterine volume at 12 or 24 months after surgery significantly reduced in group B than in group A (P < 0.05); these parameters were statistically decreased in both groups after surgery compared with those obtained before surgery (P < 0.001). Moreover, serum CA125 levels and uterine volume at six months of follow up were significantly lower in group B than in group A (P < 0.01). In addition, blood loss during surgery was similar in groups A and B (P > 0.05), although the operative time was significantly longer in group B than that in group A (P < 0.05).ConclusionsLaparoscopic adenomyomectomy using the double-flap method may be an effective technique to treat uterine diffuse adenomyosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis

Huang

Chen

et al. 2015

BMC Women's Health

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“…Pregnancy outcome after cytoreductive surgery is reported in Figure 3. This figure covers reported studies (all are case series; case reports are not included) (56)(57)(58)(59)(60)(61)(62)(63)(64) of women trying to conceive after cytoreductive surgery for AD. Some women received ART, whereas others conceived without fertility treatment.…”

Section: Cytoreductive Surgerymentioning

confidence: 99%

Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery

Dueholm

2017

Acta Obstet Gynecol Scand

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This review includes an analysis of the clinical studies evaluating reproductive outcome and adenomyosis, and a review of studies on reproductive outcome and surgical treatment options for adenomyosis. Strict diagnostic criteria and classification of disease are needed for an image diagnosis of adenomyosis. Studies of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) populations and women with surgically treated deep endometriosis have suggested that adenomyosis has a negative impact on reproductive outcome, although there are substantial variations between studies. Few data are available on the relation between the extent of disease and impact on reproductive outcome, but a correlation appears to exist. Case series seem to confirm a positive effect of gonadotropin-releasing hormone analog treatment and surgery on reproductive outcome, but there are no controlled trials. Evidence is impaired by the poor quality of many studies, a lack of strict image diagnosis, and the absence of a classification of the extent of disease. Selection of the optimal evidence-based treatment options for adenomyosis in the fertility clinic is difficult because of a lack of evidence regarding the relation between fertility and the degree and composition of adenomyosis. Adenomyosis may reduce implantation so severely that surgical or other treatment options should be recommended, but the benefit of these treatment options needs to be verified. Referral of women with adenomyosis and recurrent miscarriage and repeated failure of assisted reproductive technology to centers with a special interest in adenomyosis research and treatment may be critical.

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“…As for spontaneous pregnancies, the overall clinical pregnancy rate was very low (18.2%). However, when using GnRH-a for 24 weeks after surgery [58,59], the pooled spontaneous pregnancy rate was higher than not using adjuvant GnRH-a. There was no significant difference between pooled results with or without GnRH-a after adenomyomectomy for pregnancy rate, live birth rate, IVF pregnancy rate, or miscarriage rate.…”

Section: Different Complete Adenomyomectomy Techniques (A) Classic Tmentioning

confidence: 88%

Benefits of Surgical Intervention in Women with Endometriosis-Related Infertility

Alexander¹,

Alexey²,

Anton³

et al. 2021

Endometriosis

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Endometriosis is one of the most common gynecological diseases in the world with a great variety of symptoms and clinical features. The true prevalence rates in the general population are not known, but according to different authors, endometriosis is to be found in 10% in women of reproductive age. According to different publications, around half of the patients with infertility were diagnosed with endometriosis which change the significance of this disease from the only female to a socio-economical problem. In this chapter, we will focus on the current view on endometriosis-associated infertility, from superficial to adenomyosis, with a closer view of surgical treatment, as it is still the standard of care for diagnosis and in severe cases-treatment of the disease.

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Fertility outcome of infertile women with adenomyosis treated with the combination of a conservative microsurgical technique and GnRH agonist: Long-term follow-up in a series of nine patients

Cited by 55 publications

References 37 publications

Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis

Efficacy of laparoscopic adenomyomectomy using double-flap method for diffuse uterine adenomyosis

Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery

Benefits of Surgical Intervention in Women with Endometriosis-Related Infertility

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