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Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis

Medicine (Baltimore), 2023-03, Vol.102 (13), p.e33266-e33266 [Peer Reviewed Journal]

Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. ;Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. 2023 ;ISSN: 0025-7974 ;EISSN: 1536-5964 ;DOI: 10.1097/MD.0000000000033266 ;PMID: 37000061

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  • Title:
    Clinical efficacy of a novel method of fertility-preserving adenomyomectomy in infertile women with diffuse adenomyosis
  • Author: Yoon, Sang Ho ; Lee, Grace J ; Cho, Hye Jung ; Kwon, Hayan ; Yun, Bo Seong ; Lee, Chae Hyeong ; Park, Hyun Soo ; Roh, Ju-Won
  • Subjects: Adenomyosis - complications ; Adenomyosis - surgery ; Dysmenorrhea - etiology ; Dysmenorrhea - surgery ; Female ; Humans ; Infertility, Female - complications ; Infertility, Female - surgery ; Menorrhagia ; Observational Study ; Pregnancy ; Prospective Studies ; Treatment Outcome
  • Is Part Of: Medicine (Baltimore), 2023-03, Vol.102 (13), p.e33266-e33266
  • Description: Beneficial and detrimental effect of surgical adenomyomectomy is still controversial in infertile women with severely diffuse adenomyosis. The primary objective of this study was to assess whether a novel method of fertility-preserving adenomyomectomy could improve pregnancy rates. The secondary objective was to evaluate whether it could improve dysmenorrhea and menorrhagia symptoms in infertile patients with severe adenomyosis. A prospective clinical trial was conducted between December 2007 and September 2016. Fifty women with infertility due to adenomyosis were enrolled in this study after clinical assessments by infertility experts. A novel method of fertility-preserving adenomyomectomy was performed on 45 of 50 patients. The procedure included T- or transverse H-incision of the uterine serosa followed by preparation of the serosal flap, excision of the adenomyotic tissue using argon laser under ultrasonographic monitoring, and a novel technique of suturing between the residual myometrium and serosal flap. After the adenomyomectomy, the changes in the amount of menstrual blood, relief of dysmenorrhea, pregnancy outcomes, clinical characteristics, and surgical features were recorded and analyzed. All patients obtained dysmenorrhea relief 6 months postoperatively (numeric rating scale [NRS]; 7.28 ± 2.30 vs 1.56 ± 1.30, P < .001). The amount of menstrual blood decreased significantly (140.44 ± 91.68 vs 66.33 ± 65.85 mL, P < .05). Of the 33 patients who attempted pregnancy postoperatively, 18 (54.5%) conceived either by natural means, in vitro fertilization and embryo transfer (IVF-ET), or thawing embryo transfer. Miscarriage occurred in 8 patients, while 10 (30.3%) had viable pregnancies. This novel method of adenomyomectomy resulted in improved pregnancy rates, as well as relief of dysmenorrhea and menorrhagia. This operation is effective in preserving fertility potential in infertile women with diffuse adenomyosis.
  • Publisher: United States: Lippincott Williams & Wilkins
  • Language: English
  • Identifier: ISSN: 0025-7974
    EISSN: 1536-5964
    DOI: 10.1097/MD.0000000000033266
    PMID: 37000061
  • Source: Journals@Ovid Open Access Journal Collection Rolling
    Wolters Kluwer Open Health
    MEDLINE
    PubMed Central
    DOAJ Directory of Open Access Journals
    IngentaConnect Open Access Journals
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