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Female Infertility


What is adenomyosis?

Adenomyosis is a condition in which the inner lining of the uterus (endometrium) grows into the muscular portion of the uterus (myometrium). A woman with this condition may notice increasing abdominal pressure and bloating before periods as well as heavy cramping with periods.

Our Austin fertility doctors can detect adenomyosis using high-resolution ultrasound or MRI. On imaging, the uterus is typically enlarged, often with an abnormally thickened uterine wall. Risk factors for this condition include a history of pregnancy as well as a history of uterine surgery, such as a C-section or fibroid removal.

Adenomyosis is related to another common fertility ailment called endometriosis

Our Austin fertility doctors treat many women with endometriosis. This condition affects 10% of reproductive-aged women. It occurs when the endometrium grows outside the uterus, such as on the ovaries and fallopian tubes. Somewhere between 30% and 70% of patients with endometriosis also have adenomyosis.

Although endometriosis has a clear effect on infertility, it is less clear how much of an effect adenomyosis has on fertility. However, the more distorted the uterus is by this condition, the more likely a woman is to have fertility issues.

Treatment of this condition in the setting of infertility is controversial

The treatment of adenomyosis depends on a woman’s desire to have children. If a patient does not desire a child, a hysterectomy is the most definitive treatment. Another option is the use of hormones to subdue the condition temporarily. Other possible options include uterine artery embolization, endometrial ablation and MRI-guided focused ultrasound surgery.

If a patient with adenomyosis wants to have children, the treatment is much more controversial. Because the abnormal tissue deeply invades the uterine muscle, it is often impossible to separate the two surgically. Sometimes, patients will have a specific collection of adenomyosis called an adenomyoma. In this case, surgery may be able to remove the thickened tissue. This should only be done by a surgeon experienced in treating this condition.

If you suspect that you may have adenomyosis, contact us to schedule an appointment to discuss your options.

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