Recent Advances in Preconceptional Management of Adenomyosis with references
Adenomyosis is a common gynecological condition characterized by the presence of endometrial glands and stroma within the myometrium.
It can cause a range of symptoms, including heavy menstrual bleeding, dysmenorrhea, and infertility. Recent advances in preconceptional management of adenomyosis have focused on improving fertility outcomes and reducing the risk of complications during pregnancy.
Gonadotropin-releasing hormone (GnRH) agonists have been used to suppress ovarian function and decrease the size of adenomyosis lesions prior to conception. In a study by Luo et al., the use of GnRH agonists for three months prior to in vitro fertilization (IVF) significantly improved pregnancy rates in women with adenomyosis compared to those who did not receive treatment (1).
Hysteroscopic resection of adenomyosis lesions has been shown to improve pregnancy rates in women with adenomyosis. In a study by Li et al., hysteroscopic resection of adenomyosis lesions prior to IVF resulted in a significantly higher clinical pregnancy rate compared to IVF alone (2).
Magnetic resonance imaging (MRI) has been used to accurately diagnose adenomyosis and assess the extent and severity of the disease. Three-dimensional (3D) MRI techniques have also been developed to provide a more detailed assessment of adenomyosis lesions and their relationship to surrounding structures.
Personalized treatment based on the individual characteristics of adenomyosis lesions has been proposed as a potential approach to improve preconceptional management. In a study by Zhang et al., women with adenomyosis were classified into two subtypes based on the MRI characteristics of their lesions. Women in one subtype had a higher likelihood of pregnancy success with IVF, while women in the other subtype had a higher risk of miscarriage (3).