Adenomyosis and Infertility

Adenomyosis is a very difficult disease to have when hoping for fertility. Many patients will consult with their gynecologist for heavy bleeding, clots and significant monthly pain during and around periods.This presentation is timely and relevant for several reasons. The incidence of adenomyosis begins to rise from the mid-thirties. Moreover, more women are delaying their first pregnancy until later in their thirties or forties, and consequently adenomyosis is encountered more frequently in the fertility clinic during di-agnostic work-up. Furthermore, it is difficult to diagnose ad-enomyosis before surgery, because there are no pathognomonic signs, symptoms or physical findings. Finally, reference data are very limited.Adenomyosis remains a fairly frequent and debilitating disease that will be encountered with increasing incidence in the infer-tile female population. While spectacular advances have been made in recent years in the non-invasive diagnosis of the condi-tion, non-surgical treatment options for infertile patients with adenomyosis arise but need to be confirmed in larger series. To date, there is no consensus for the most appropriate treatment of adenomyosis with infertility. Conservative surgery could be effective option to treat adenomyosis, especially in women who seek fertility preservation and, in women with previous history of IVF failure. However, the latter finding could be partly at-tributed to the higher rate of early miscarriage. In this presen-tation, reported data regarding treatment of adenomyosis were summarized and then the most appropriate approach to treat in-fertility associated with adenomyosis will be discussed.