Adenomyosis in endometriosis—Prevalence and impact on fertility. Evidence from magnetic resonance imaging
Abstract
BACKGROUND: The hypothesis is tested that there is a strong association between endometriosis and adenomyosis and that adenomyosis plays a role in causing infertility in women with endometriosis. METHODS. Magnetic resonance imaging of the uteri was performed in 160 women with and 67 women without endometriosis. The findings were correlated with the stage of the disease, the age of the women and the sperm count parameters of the respective partners. RESULTS: The posterior junctional zone (PJZ) was significantly thicker in women with endometriosis than in those without the disease (P<0.001). There was a positive correlation of the diameter of the PJZ with the stage of the disease and the age of the patients. The PJZ was thicker in patients with endometriosis with fertile than in patients with subfertile partners. The prevalence of adenomyotic lesions in all 160 women with endometriosis was 79%. In women with endometriosis below an age of 36 years and fertile partners, the prevalence of adenomyosis was 90% (P<0.01) CONCLUSIONS: With a prevalence of up to 90%, uterine adenomyosis is significantly associated with pelvic endometriosis and constitutes an important factor of sterility in endometriosis presumably by impairing uterine sperm transport.
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There is a strong association between AM and EM.
“Kunz et al. confirmed the strong association between AM and EM in extensive radiological examinations of women with an unfulfilled desire to have children [10].”
From Women with Endometriosis—Who Is at Risk for Complications Associated with Pregnancy and Childbirth? A Retrospective Case–Control Study (2024) · cites this paper as [10]
Adenomyotic foci are usually localized in the anterior and/or posterior with preference of the posterior but only rarely in the lateral walls of the uterine corpus.
“Adenomyotic foci are usually localized in the anterior and/or posterior with preference of the posterior but only rarely in the lateral walls of the uterine corpus.”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [23]
There is a significant association of pelvic endometriosis with uterine adenomyosis in women and in the baboon with life-long infertility.
“There is a significant association of pelvic endometriosis with uterine adenomyosis in women and in the baboon with life-long infertility.”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [23]
Early lesions usually present close to the fundo-cornual raphe of the archimyometrium.
“Early lesions usually present close to the “fundo-cornual raphe” of the archimyometrium [3, 23, 45]”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [23]
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“Kunz et al. confirmed the strong association between AM and EM in extensive radiological examinations of women with an unfulfilled desire to have children [10].”
Background
- Authors
- Kunz, G., Beil, D., Huppert, P., Noe, M., Kissler, S., & Leyendecker, G.
- Affiliations
- Klinikum Darmstadt (DE)
- University of Vienna (AT)
- Goethe University Frankfurt (DE)
- Corresponding author
- Kunz, G.
- ORCID
- Kunz, G.
- Venue
- Human Reproduction
- Publisher
- Oxford University Press (OUP)
- Published
- 2005-06-02
- Volume
- 20
- Issue
- 8
- Pages
- 2309-2316
- ISSN
- 0268-1161 (ISSN-L)
- 1460-2350
- OpenAlex
- W2383824503
- Cited by
- 377
- References
- 44
- Citations by year
- 2026: 17 · 2025: 10 · 2024: 19 · 2023: 11 · 2022: 19 · 2021: 34 · 2020: 22 · 2019: 14 · 2018: 26 · 2017: 29 · 2016: 24 · 2015: 18 · 2014: 26 · 2013: 12 · 2012: 17
- FWCI
- 12.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Human Reproduction (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- adenomyosis, endometriosis, infertility, endometriosis stage, maternal age
- MeSH terms
- Adolescent, Adult, Endometriosis, Endometrium, Female, Fertility, Humans, Infertility, Female, Magnetic Resonance Imaging, Male, Middle Aged, Sperm Count, Prevalence
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