Adenomyosis decreases the live birth rate but may not affect perinatal outcomes in assisted reproductive cycles

Abstract

Objective To determine if uterine adenomyosis is associated with worse perinatal outcomes in ovum donation assisted reproductive treatment cycles. Materials and Methods A multicenter and retrospective cohort study in which a total of 3307 patients undergoing an ovum donation cycle in 2018–2019 were included and divided into two groups: adenomyosis (n = 179) and controls (n = 3128). Clinical, obstetrical, and perinatal outcomes were analyzed. Results A lower live birth rate per embryo transfer was observed in women diagnosed with adenomyosis versus control women: 67/179 (37%) versus 1560/3128 (49.9%), respectively (odds ratio 0.6, 95% confidence interval 0.43–0.83, P = 0.002). There was no statistically significant difference in childbirth delivery method (vaginal versus cesarean section) between the adenomyosis and control groups. Mean gestational age at the time of delivery, newborn length and weight, and incidences of low birth weight, preterm birth, and admission to the neonatal intensive care unit did not differ between the two groups. In addition, in vitro fertilization and perinatal outcomes were similar in patients with diffuse compared with focal adenomyosis. Conclusions Adenomyosis affects clinical but may not affect perinatal outcomes in ovum donation cycles.

Prevalence of adenomyosis in women with subfertility: systematic review and meta‐analysis

“…When possible, we attempted to contact the authors of 26 studies to obtain relevant study details and missing data (Table S3). At the time of writing, we received responses for nine studies 23,27,28,55–60 , of which four were included 23,27,56,59 and five excluded 28,55,57,58,60 . A total of 21 studies were included in the final qualitative and quantitative syntheses 8,14–16,18,20,22–24,27,50,56,59,61–68 .…”

“…At the time of writing, we received responses for nine studies 23,27,28,[55][56][57][58][59][60] , of which four were included 23,27,56,59 and five excluded 28,55,57,58,60 . A total of 21 studies were included in the final qualitative and quantitative syntheses 8,[14][15][16]18,20,[22][23][24]27,50,56,59,[61][62][63][64][65][66][67][68] .…”

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

“…After removing 302 duplicates and excluding 97 studies based on the title and abstract screening, 78 articles were fully reviewed, of which 18 were deemed eligible for final quantitative analysis. The US features used in the diagnosis of adenomyosis in the included studies were as follows: myometrial cysts (12/13), myometrial wall asymmetry (9/13), irregular endometrial–myometrial junction (9/13), heterogeneous echogenicity (9/13), linear striations radiating out from the myometrium (9/13), global uterine enlargement (5/13), fan‐shaped shadowing (3/13), ill‐defined myometrial lesions (1/13), subendometrial echogenic nodules (1/13), hyperechoic islands (1/13), and adenomyomas (1/13) 7–19 . Furthermore, only two studies used three‐dimensional US and only one study descripted sonographic features in accordance with terms defined by the morphological uterus sonographic assessment (MUSA) group.…”

“…The US features used in the diagnosis of adenomyosis in the included studies were as follows: myometrial cysts (12/13), myometrial wall asymmetry (9/13), irregular endometrial–myometrial junction (9/13), heterogeneous echogenicity (9/13), linear striations radiating out from the myometrium (9/13), global uterine enlargement (5/13), fan‐shaped shadowing (3/13), ill‐defined myometrial lesions (1/13), subendometrial echogenic nodules (1/13), hyperechoic islands (1/13), and adenomyomas (1/13). 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 Furthermore, only two studies used three‐dimensional US and only one study descripted sonographic features in accordance with terms defined by the morphological uterus sonographic assessment (MUSA) group. The characteristics of the studies included in the quantitative analysis are summarized in Table 1 .…”