The Impact of Conservative Surgical Treatment of Adenomyosis on Fertility and Perinatal Outcomes

Author:

Moawad Gaby12ORCID,Youssef Youssef3ORCID,Fruscalzo Arrigo4ORCID,Faysal Hani5,Merida Manuel6,Pirtea Paul7ORCID,Guani Benedetta4ORCID,Ayoubi Jean Marc7,Feki Anis4ORCID

Affiliation:

1. Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC 20037, USA

2. The Center for Endometriosis and Advanced Pelvic Surgery, Washington, DC 22101, USA

3. Division of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY 11219, USA

4. Department of Obstetrics and Gynecology, HFR—Hòpital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland

5. Department of Obstetrics and Gynecology, Indiana University, Indianapolis, IN 46204, USA

6. Department of Obstetrics and Gynecology, Hurley Medical Center, Michigan State University, Flint, MI 48503, USA

7. Department of Obstetrics and Gynecology and Reproductive Medicine, Faculté de Médecine Paris, Hopital Foch, 92150 Suresnes, France

Abstract

Adenomyosis is a benign condition commonly encountered in patients with infertility. While the definitive surgical management is hysterectomy, conservative surgical management is gaining attention in patients desiring future fertility. This review explores whether the surgical treatment of adenomyosis affects fertility outcomes for patients trying to conceive. The PubMed and Medline databases were searched using the keywords: “adenomyosis”, “surgery”, “radiofrequency”, “infertility”, “pregnancy”, “sterility”, “conception”, “miscarriage”, and “endometrial receptivity”. Abstracts were screened, and relevant articles were selected for review. This review reveals that surgery appears to improve fertility outcomes with or without medical therapy; however, the risk of uterine rupture remains high and the best technique to reduce this risk is still not known. More studies are needed to formulate the best surgical approach for preserving fertility in treating adenomyosis and to establish standardized guidelines.

Publisher

MDPI AG

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