This literature review is based on resources from the following databases: CyberLeninka, PubMed, MedArt, and the Central Scientific Medical Library (I.M. Sechenov First Moscow State Medical University, Moscow, Russia). Adenomyosis is a common non-infectious uterine pathology associated with the risk of infertility and obstetric problems. The local inflammation that develops in adenomyosis reduces the probability of blastocyst implantation and creates an unfavorable environment for the development of the embryo. Adenomyosis reduces the effectiveness of assisted reproductive technology. During the pregnancy in adenomyosis, the risk of incomplete and prolonged pregnancy increases at almost all stages. Besides, the risk of massive hemorrhage increases during pregnancy, childbirth and the early postpartum period. The presented review helps to assess the pathogenetic mechanisms underlying the negative effect of adenomyosis on womens fertility based on data obtained over the past ten years.