Uterotubal transport disorder in adenomyosis and endometriosis—a cause for infertility
Abstract
Objective Uterine hyperperistalsis and dysperistalsis are common phenomena in endometriosis and may be responsible for reduced fertility in cases of minimal or mild extent of disease. Since a high prevalence of adenomyosis uteri has been well documented in association with endometriosis, we designed a study to examine whether hyperperistalsis and dysperistalsis are caused by the endometriosis itself or by the adenomyotic component of the disease. Design A prospective observational study. Setting University hospital, Department of Obstetrics and Gynaecology, Division of Reproductive Medicine and Gynaecologic Endocrinology with 300 in vitro fertilisation/intracytoplasmatic sperm injection cycles and 350 intrauterine insemination cycles/year. Population Forty‐one subjects with infertility and with laparoscopically proven endometriosis and patent fallopian tubes. Thirty‐five subjects (85%) additionally showed signs of adenomyosis. Methods All subjects underwent T2‐weighed magnetic resonance imaging (MRI) and hysterosalpingoscintigraphy (HSSG) during the subsequent menstrual cycle. MRI revealed the extent of the adenomyotic component of the disease and the integrity of uterotubal transport capacity was evaluated by HSSG. Main outcome measures Influence of adenomyosis on uterotubal transport capacity in endometriosis. Results In 35 of the 41 subjects (85%) with endometriosis, signs of adenomyosis were detected using T2‐weighed MRI. Two of six (33%) subjects with no adenomyosis (group I) showed dysperistalsis and hyperperistalsis, compared with 14 of 24 (58%) women with focal adenomyosis (group II) and 10 of 11 (91%) women with diffuse adenomyosis (seven showed a failure in transport capacity and two contralateral transport). Conclusions Our data suggest that endometriosis is associated with impeded hyperperistaltic and dysperistaltic uterotubal transport capacity. However, adenomyosis is of even more importance, especially when diffuse adenomyosis is detected. Both forms of adenomyosis are commonly found in subjects with mild to moderate endometriosis. We suggest that the extent of the adenomyotic component in subjects with endometriosis explains much of the reduced fertility in subjects with intact tubo‐ovarian anatomy.
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Uterine function of rapid and directed sperm transport into the dominant tube is dysfunctional in women with endometriosis and is characterized by hyper- and dysperistalsis.
“The uterine function of rapid and directed sperm transport into the ‘dominant tube’ is dysfunctional in women with endometriosis and is characterized by hyper- and dysperistalsis [27–32].”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [31]
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- Authors
- Kissler, S., Hamscho, N., Zangos, S., Wiegratz, I., Schlichter, S., Menzel, C., Doebert, N., Gruenwald, F., Vogl, T., Gaetje, R., Rody, A., Siebzehnruebl, E., Kunz, G., Leyendecker, G., & Kaufmann, M.
- Affiliations
- Goethe University Frankfurt (DE)
- Corresponding author
- Kissler, S
- Venue
- BJOG: An International Journal of Obstetrics & Gynaecology
- Publisher
- Wiley
- Published
- 2006-07-18
- Volume
- 113
- Issue
- 8
- Pages
- 902-908
- ISSN
- 0306-5456 (ISSN-L)
- 1470-0328
- 1471-0528
- OpenAlex
- W2018293476
- Cited by
- 146
- References
- 28
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 9 · 2023: 13 · 2022: 8 · 2021: 13 · 2020: 12 · 2019: 10 · 2018: 2 · 2017: 9 · 2016: 6 · 2015: 8 · 2014: 11 · 2013: 6 · 2012: 5
- FWCI
- 3.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- BJOG An International Journal of Obstetrics & Gynaecology (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 › Surgery › Diagnosis and treatment of tuberculosis
- Keywords
- adenomyosis, endometriosis, infertility, tubal patency, T2-weighted MRI, diffuse adenomyosis, focal adenomyosis, in vitro fertilization, intrauterine insemination
- MeSH terms
- Adult, Endometriosis, Fallopian Tube Diseases, Female, Humans, Infertility, Female, Magnetic Resonance Imaging, Prospective Studies, Uterine Neoplasms, Adenomyoma
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