Ultrasound findings in infertile women with endometriosis: evidence of concomitant uterine disorders

Capezzuoli, Tommaso; Vannuccini, Silvia; Fantappiè, Giulia; Orlandi, Giulia; Rizzello, Francesca; Coccia, Maria Elisabetta

doi:10.1080/09513590.2020.1736027

Cited by 27 publications

(15 citation statements)

References 24 publications

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“…Although the prevalence of adenomyosis diagnosed by histopathology at surgery in women with endometriosis ranges from 15% to 31%, 60,61 the prevalence of adenomyosis varies between 22% and 89% with TVUS, 49,62,63 and between 27% and 65% with MRI. 64,65 Higher prevalence of adenomyosis has been observed among women with endometriosis and concurrent infertility (35-79%) 59,66,67 or with endometriosis and concurrent pelvic pain/dysmenorrhea (38-87%). 68,69 Restricting to women with deep infiltrating endometriosis, overall adenomyosis prevalence is similarly high (35-78%), 65,70,71 with the highest prevalence reported for focal adenomyosis of the outer myometrium (49-97%).…”

Section: Prevalence In Women With Other Uterine-related Conditionsmentioning

confidence: 99%

Epidemiology of Adenomyosis

2020

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Adenomyosis, characterized by the presence of endometrial glands and stroma within the myometrium, can have a substantial impact on the quality of women's lives. Despite this, the epidemiologic research on this condition lags considerably behind that of other noncancerous reproductive health conditions. The lack of progress and knowledge is due in part to the challenges in designing valid epidemiologic studies, since the diagnosis of adenomyosis historically has been limited to the examination of uterine specimens from hysterectomy. This review describes the available data on the frequency of this condition and the epidemiologic investigation thus far into the risk factors for disease—highlighting the methodologic and inference challenges primarily around study sample selection. We conclude with providing recommendations for approaches to future epidemiologic study that capitalize on the advancements in imaging technology to detect adenomyosis and provide a fuller picture of the occurrence and risk factors for disease.

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Section: Prevalence In Women With Other Uterine-related Conditionsmentioning

confidence: 99%

Epidemiology of Adenomyosis

2020

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“…To date, there is no evidence in the literature of obstetrical risk reversibility after myomectomy. Seventh, the current literature, on the basis of several previously published studies, reports an incidence of concomitant fibroids and endometriosis/ adenomyosis ranging from 20% to 40% (1,(143)(144)(145)(146)(147). Considering the potential of endometriosis/adenomyosis to PRO: Intramural myomas more than 3-4 cm should be surgically removed before in vitro fertilization (continued) CON: Intramural myomas more than 3-4 cm should not be surgically removed before in vitro fertilization (continued) gain for patients and surgeons by a well-performed myomectomy through laparotomy than by a difficult laparoscopy and an inappropriate suturing.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the potential of endometriosis/adenomyosis to PRO: Intramural myomas more than 3-4 cm should be surgically removed before in vitro fertilization (continued) CON: Intramural myomas more than 3-4 cm should not be surgically removed before in vitro fertilization (continued) gain for patients and surgeons by a well-performed myomectomy through laparotomy than by a difficult laparoscopy and an inappropriate suturing. affect fertility, the coexistence of these uterine disorders would interfere and possibly worsen the chances of conception (143). Indeed, overlooking the coexistence of endometriosis/ adenomyosis in women with leiomyoma undergoing surgery may lead to suboptimal treatment of both fertility and persistent pelvic pain (121).…”

Section: Discussionmentioning

confidence: 99%

Intramural myomas more than 3–4 centimeters should be surgically removed before in vitro fertilization

Dolmans

Isaacson

Zhang

et al. 2021

Fertility and Sterility

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“…They proposed that sonographic signs of adenomyosis may be used in the assessment of and predicting the severity of endometriosis [ 27 ]. Capezzuoli et al found that 21.2% of women with confirmed endometriosis referred for infertility also had adenomyosis [ 28 ]. Our study utilized a high resolution TVUS device with an expert sonographer; therefore, we think that the diagnosis was probably of high validity.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Signs of Adenomyosis in Women with Endometriosis Are Associated with Infertility

Decter

Arbib

Markovitz

et al. 2021

JCM

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We compared the prevalence of ultrasound signs of adenomyosis in women with endometriosis who underwent surgery to those who were managed conservatively. This was a retrospective study of women evaluated at a tertiary endometriosis referral center who underwent 2D/3D transvaginal ultrasound. Adenomyosis diagnosis was based on the presence of at least three sonographic signs. The study group subsequently underwent laparoscopic surgery while the control group continued conservative management. Statistical analysis compared the two groups for demographics, symptoms, clinical data, and sonographic findings. The study and control groups included 244 and 158 women, respectively. The presence of any, 3+, or 5+ sonographic signs of adenomyosis was significantly more prevalent in the study group (OR = 1.93–2.7, p < 0.004, 95% CI; 1.24–4.09). After controlling for age, for all findings but linear striations, the OR for having a specific feature was higher in the study group. Women in the study group with ≥ 5 sonographic signs of adenomyosis had more than twice the risk of experiencing infertility (OR = 2.31, p = 0.012, 95% CI; 1.20–4.45). Sonographic signs of adenomyosis are more prevalent in women with symptomatic endometriosis who underwent surgery compared with those who continued conservative management. Women with 5+ findings have a significantly increased risk of infertility. Adenomyosis on ultrasound should be considered in the management decisions regarding these patients.

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Ultrasound findings in infertile women with endometriosis: evidence of concomitant uterine disorders

Cited by 27 publications

References 24 publications

Epidemiology of Adenomyosis

Epidemiology of Adenomyosis

Intramural myomas more than 3–4 centimeters should be surgically removed before in vitro fertilization

Sonographic Signs of Adenomyosis in Women with Endometriosis Are Associated with Infertility

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