Adenomyosis and infertility: the role of the junctional zone

Barbanti, Chiara; Centini, Gabriele; Lazzeri, Lucia; Habib, Nassir; Labanca, Luca; Zupi, Errico; Afors, Karolina; Starace, Antonella Clara

doi:10.1080/09513590.2021.1878131

Cited by 20 publications

(17 citation statements)

References 63 publications

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“…Evidence shows that diffuse adenomyosis and intrinsic adenomyosis are correlated with heavy menstrual bleeding and infertility, whereas extrinsic adenomyosis and coexistence of deep infiltrating endometriosis cause pelvic pain. 32 , 33 , 34 Although none of these classifications has been widely accepted and applied, they have a positive clinical value in mapping lesions and grading disease severity. The absence of baseline classification information in previous clinical studies leads to difficulties in comparing the results of different studies.…”

Section: Histological and Imaging Diagnosis Of Adenomyosismentioning

confidence: 99%

Ultrasound-guided microwave ablation for symptomatic adenomyosis: More areas of concern for more uniform and promising outcomes

Zhang

2022

Journal of Interventional Medicine

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Section: Histological and Imaging Diagnosis Of Adenomyosismentioning

confidence: 99%

Ultrasound-guided microwave ablation for symptomatic adenomyosis: More areas of concern for more uniform and promising outcomes

Zhang

2022

Journal of Interventional Medicine

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“…The inclusion criteria for the AG were as follows (1) women of reproductive age, 25−45-years-old, with a normal sexual life, no contraception and no pregnancy for 1 year, or having a history of pregnancy and not becoming pregnant again for 1 year; (2) normal menstrual cycle of 21−35 days with a bipolar basic temperature; (3) no abnormalities with regards to basic endocrinology; (4) no hormone therapy over the previous three months; (5) no organic lesions detected in the ovary by B ultrasound; (6) bilateral oviduct patency was con rmed by salpingography, and (7) there was no abnormality with regards to semen analysis in the spouse. The inclusion criteria for the CG group were as follows: (1) women of reproductive age, 25−45-years-old, with a normal sexual life, a history of pregnancy, and no history of infertility; (2) normal menstrual cycle of 21−35 days with a bipolar basic temperature; (3) no abnormalities with regards to basic endocrinology; (4) no hormonal therapy over the previous three months; and (5) no organic lesions in the uterus and ovary.…”

Section: Subjectsmentioning

confidence: 99%

“…However, this receptivity is restricted by both time and space (4). If the receptivity of the endometrium is reduced, embryo implantation will fail (5). Therefore, determining methods to improve endometrial receptivity has become critical in increasing the pregnancy rate.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Low Intensity Pulsed Ultrasound on Endometrial Receptivity in Infertile Patients with Adenomyosis

Лонг

Zhou

Zhu

et al. 2022

Preprint

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Objective: Adenomyosis (AM) is an important cause of female infertility, and its disease mechanism remains unclear. This study preliminarily investigated the expression of endometrial receptivity markers homeobox A10 (HOXA10) and leukemia inhibitory factor (LIF) in infertile patients with AM and described the effects of low intensity pulsed ultrasound (LIPUS) on it. Methods: In vivo, tissues were obtained from the infertile female AM patient group (AG group, n=10) and healthy control group (CG group, n=11). The expression of HOXA10 and LIF in the two groups was detected by immunohistochemistry (IHC) and western blotting. In vitro, primary cells were extracted and cultured from the two groups, and the expression of HOXA10 and LIF protein was detected by western blotting. Then the AG cells were treated with 15, 30, and 60 mW/cm2 of LIPUS for 7 days (20 min/day), and detected the cell adhesion rate. Finally, treat the AG cells with 30mW/cm2 LIPUS for 7 days (20 min/day), and detect the expression level of ICAM-1 in the cell supernatant by ELISA. The AG cells was treated with 30 mW/cm2 LIPUS for 4 days (20 min/day), and the expression levels of HOXA10 and LIF were detected by western blotting, RT-PCR, and agarose gel electrophoresis. Results: In vivo, IHC staining showed that HOXA10 and LIF proteins were mainly localized in endometrial epithelial cells. Both IHC and western blot showed that the levels of HOXA10 and LIF in the AG group were significantly lower than those in the CG group (P<0.01, P<0.05). In vitro, the expression levels of HOXA10 and LIF protein in the AG cell was significantly lower than those in the CG cell (P<0.001). Then, the cell adhesion ability of the 30 and 60 mW/cm2 groups was higher than that of the 15 mW/cm2 group after LIPUS treatment. Finally, The concentration of ICAM-1 in the supernatant of AG cells treated with LIPUS was significantly higher than that of the control group (P<0.01), and the AG cells were treated with 30 mW/cm2 LIPUS for 4 days (20 min/day), the protein and mRNA expression levels of HOXA10 and LIF were higher than those of the control group (P<0.001). Conclusion: The reduction of HOXA10 and LIF may be one of the reasons for the decreased endometrial receptivity in AM. The LIPUS promoted the adhesion and the expression of HOXA10 and LIF of EEECs from the AM group, thereby increasing endometrial receptivity.

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“…12 Junctional zon, T2 ağırlıklı manyetik rezonans görüntülemede koyu bir bant olarak görünen, subendometrial myometriyumu dış myometriyumdan ayıran ancak histolojik olarak tanımlanamayan bir bölgedir. 13 Çalışmalar, bu bölgenin fizyolojiyi etkileyebi-lecek değişikliklere ve farklı büyüme faktörü ekspresyonuna sahip olduğunu göstermektedir.…”

Section: Etiyopatogenez Ve Risk Faktörleriunclassified

Adenomyosis; Diagnosis, Clinical Findings and Current Approaches to Treatment

ERTAN¹,

AKDÖNER²,

YAVUZ³

et al. 2022

TJRMS

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Adenomyozis, endometriyal bez ve/veya stromanın hiperplastik ve hipertrofik myometriyum içinde bulunmasıdır. Histopatolojik olarak, diffüz ve fokal(adenomyoma) olmak üzere iki ana tipi vardır. Patogenezde junctional zonun anahtar rol oynadığı düşünülmektedir. Risk faktörleri net olmamakla birlikte perimenopozal ve multiparöz kadınlarda daha sık saptanmaktadır. Adenomyozisli hastaların 1/3'ü asemptomatiktir, geriye kalan hastalarda en sık görülen semptomlar ağır menstrüel kanama ve dismenoredir. Tanıda ilk tercih transvajinal ultrasonografidir. Şüphelenilen veya diğer benign uterin patolojilerle arada kalınan vakalarda manyetik rezonans görüntüleme tercih edilebilir. Tedavide ilk sorulacak soru gelecekteki fertilite arzusudur. Fertilitesini tamamlamış kadınlarda histerektomi küratif tedavi yöntemidir. Ayrıca hastalığın kesin tanısı da histolojik spesimen incelemesi ile konulmaktadır. Fertilite arzusu olan kadınlarda uterus koruyucu rezeksiyon tercih edilebilir. Bunun dışında medikal tedavi, endometrial ablasyon ve uterin arter embolizasyonu da tercih edilebilir.Anah tar Ke li me ler: Adenomyozis; ultrasonografi; manyetik rezonans görüntüleme; leiyomyoma ABS TRACTAdenomyosis is the presence of endometrial gland and/or stroma within the hyperplastic and hypertrophic myometrium. Histopathologically, there are two main types as diffuse and focal (adenomyoma). The junctional zone is thought to play a key role in the pathogenesis. Although the risk factors are not clear, they are more common in perimenopausal and multiparous women. 1/3 of patients with adenomyosis are asymptomatic, the most common symptoms in the remaining patients are heavy menstrual bleeding and dysmenorrhea. The first choice for diagnosis is transvaginal ultrasonography. Magnetic resonance imaging may be preferred in suspected cases or other benign uterine pathologies. The first question in the treatment is the desire for future fertility. Hysterectomy is a curative treatment method in women who have completed their fertility. In addition, the definitive diagnosis of the disease is made by histological specimen examination. Uterine-sparing resection may be preferred in women with a desire for fertility. Apart from this, medical treatment, endometrial ablation and uterine artery embolization may also be preferred.

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Adenomyosis and infertility: the role of the junctional zone

Cited by 20 publications

References 63 publications

Ultrasound-guided microwave ablation for symptomatic adenomyosis: More areas of concern for more uniform and promising outcomes

Ultrasound-guided microwave ablation for symptomatic adenomyosis: More areas of concern for more uniform and promising outcomes

The Effect of Low Intensity Pulsed Ultrasound on Endometrial Receptivity in Infertile Patients with Adenomyosis

Adenomyosis; Diagnosis, Clinical Findings and Current Approaches to Treatment

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