How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic

Naftalin, J.; Hoo, W.; Pateman, K.; Mavrelos, D.; Holland, Tom; Jurkovic, D.

doi:10.1093/humrep/des332

Cited by 267 publications

(270 citation statements)

References 25 publications

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“…2) the inflammatory process whose consequences can be manifested also at endometrial level with in particular an increased release of reactive oxygen species (2), 3) the inadequate uterine contractility (28), 4) the well-known association with adenomyosis (29,30) that was suggested to increase the risk of abortion on its own (31). On the other hand, it is intriguing to note that several characteristics of the endometrium that are deemed essential to allow the implantation of the embryo are also concomitantly involved in the pathogenesis of endometriosis.…”

Section: Discussionmentioning

confidence: 99%

Risk of miscarriage in women with endometriosis: insights from in vitro fertilization cycles

Leonardi

Papaleo

Reschini

et al. 2016

Fertility and Sterility

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CapsuleWomen with endometriosis achieving singleton pregnancies with in vitro fertilization do not face an increased risk of miscarriage. Patients: Women achieving singleton pregnancies with the use of IVF were considered. Cases were women with a history of surgery for endometriosis and those who were documented the presence of ovarian endometriomas at the time of the IVF cycle (n=313). Controls were matched to cases by age (± 6 months), type of cycle (fresh or frozen cycle) and study period (n=313).Interventions: Retrospective review of women undergoing IVF. Main outcome measures: Rate of miscarriage before 12 weeks' gestationResults: The number of miscarriages in women with and without endometriosis was similar, being 48 (15%) and 60 (19%), respectively. The Odds Ratio (OR) of miscarriage in affected women was 0.76 (95%CI: 0.50-1.16). The OR adjusted for body mass index, parity, duration of infertility and male factor was 0.81 (95%CI: 0.53-1.25). Subgroup analyses according to the type of cycle, the number of embryos transferred, the presence of endometriomas and the history of surgery for endometriosis did not document any subgroup at significant increased risk of miscarriage. Conclusions:The risk of miscarriage is not increased in women with endometriosis achieving pregnancy with the use of IVF.

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Section: Discussionmentioning

confidence: 99%

Risk of miscarriage in women with endometriosis: insights from in vitro fertilization cycles

Leonardi

Papaleo

Reschini

et al. 2016

Fertility and Sterility

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“…Diagnosis can now also be made using imaging techniques such as MRI or transvaginal ultrasound. A recent ultrasound study of 985 symptomatic women attending a gynecology clinic noted adenomyosis in 20.9%, with good correlation between ultrasound and histological diagnosis in the 45 women who subsequently had a hysterectomy [48]. Adenomyosis is commonest in women of late reproductive age and the majority of women with this condition are parous [48].…”

Section: Adenomyosismentioning

confidence: 99%

Pathophysiology of Heavy Menstrual Bleeding

Hapangama

Bulmer

2016

Womens Health (Lond Engl)

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Heavy menstrual bleeding (HMB) is a common gynecological complaint with multiple etiologies and diverse pathophysiological origins. This review discusses HMB with reference to the recently proposed PALM-COEIN classification system for abnormal uterine bleeding, initially describing the endometrial events in normal menstruation followed by discussion of the perturbations of normal endometrial shedding that can result in HMB. Our present understanding of the mechanisms of menstrual bleeding as well as many of the pathological aberrations of HMB is incomplete. Further research into the pathophysiology of HMB is urgently needed, as clear knowledge of the mechanisms of this disorder will provide new therapeutic targets to formulate more effective treatments. Keywords: endometrial cancer • endometrial hyperplasia • heavy menstrual bleeding • leiomyoma/fibroid • polycystic ovarian syndromeIn the developed world an average woman undergoes ∼400 repetitive cycles of monthly menstrual bleeding with shedding of her superficial endometrial functional layer. In as many as 20-30% of women, this bleeding is excessive and is termed heavy menstrual bleeding (HMB) [1]. Apart from the physical symptoms of anemia (fatigue, lethargy and exertional dyspnea), HMB can interfere with normal daily life and may affect the social and emotional well being of women, reducing their productivity in society. HMB commonly presents to primary and secondary healthcare providers, with over 1.5 million women suffering from this problem in England and Wales alone [1]. It is the fourth most common reason for secondary gynecological referrals and each year over 30,000 women in England and Wales undergo surgical treatment for HMB [1]. The annual cost to the National Health Service in 2000 was estimated to be over GB£65 million [2] and with the spiraling cost of healthcare provision, it is clear that the current cost of HMB to women, society and the National Health Service is huge.In this review HMB will be discussed with reference to the recently proposed polyps; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic and not yet classified (PALM-COEIN) classification system for abnormal uterine bleeding (AUB), approved by the International Federation of Gynecology and Obstetrics [3]. HMB can present as a chronic disorder of over 12 months duration or as an acute increase in bleeding over a short time period. The age at presentation can range from adolescence to the perimenopausal phase and HMB may occur in the context of either ovulatory or anovulatory cycles. This review will briefly describe the endometrial events in normal menstruation followed by discussion of the perturbations of normal endometrial shedding that can result in HMB. Normal menstruationThe purpose of menstruation is unknown but it is a phenomenon confined mainly to the upper order primates and humans [4], suggesting an associated evolutionary advan- tage. The morphology of human endometrium, relatively greater quantity of menstr...

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“…The prevalence varied with ethnicity, ranging from 18% to 31%, with the highest prevalence in women of Asian origin, and lowest among those who identified themselves as mixed/other origin. It was noted that women with a past or current history of endometriosis were more likely to have adenomyosis, 9 and retrospective data found a prevalence of 21.8% in women undergoing surgery for endometriosis. 10 …”

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MR-guided focused ultrasound for the treatment of adenomyosis: current insights

Chin¹,

Walbridge²,

Quinn³

2015

RRFU

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Adenomyosis is a benign gynecological condition causing significant morbidity among women of reproductive age. The available treatments are currently limited in number and efficacy. While hysterectomy is curative, it is unacceptable to many women, particularly those wishing to conserve their fertility. Magnetic resonance-guided focused ultrasound surgery is a noninvasive treatment method that has been used to effectively treat uterine leiomyomata, but until recently has not been routinely used to treat adenomyosis. This review summarizes the current understanding of adenomyosis and high-intensity focused ultrasound, and the recent research into the safety and efficacy of this technique.

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How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic

Abstract: The authors have no competing interests to declare. The study was not supported by an external grant.

Cited by 267 publications

References 25 publications

Risk of miscarriage in women with endometriosis: insights from in vitro fertilization cycles

Risk of miscarriage in women with endometriosis: insights from in vitro fertilization cycles

Pathophysiology of Heavy Menstrual Bleeding

MR-guided focused ultrasound for the treatment of adenomyosis: current insights

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