Adenomyosis – the possible effect on endometrial function and receptivity

Abstract

Objective: There have been many studies on adenomyosis, which can impair the quality of life of a woman. There are various kind of opinion on pathogenesis, diagnostics and treatment of adenomyosis. The goal of this article is to present the current knowledge of adenomyosis and its impact on the endometrial function and receptivity.

Design:  Review article

Setting: Department of Obstetrics and Gynecology, Faculty of Medicine,  Masaryk university and University Hospital Brno

Department of Obstetrics and Gynecology, University Hospital Faculty of Medicine, Palacky University, Olomouc

Methods: PubMed/Medline, WoS and Scopus were searched for articles in English indexed 

until February 2021 with terms of: adenomyosis, endometrial receptivity, infertility.

Text: Recent studies on angiogenesis and epithelial-mesenchymal transition (EMT) in endometrium bring new information on ethiology and pathogenesis of adenomyosis.

In clinical practice, the main diagnostic method of adenomyosis is transvaginal ultrasound, MRI or hysteroscopy, although definitive confirmation is set by histopathological examination. The rules of #Enzian classification of endometriosis should be appled for classifacation of adenomyosis. Treatment of adenomyosis should consider individual clinical presentation and reproductive plans of a patient and should be performed in centres for treatment of endometriosis

Conclusion:  Adenomyosis affects endometrial vascularisation and EMT, thus can be the cause of irregular uterine bleeding or embryo implantation failure. Research and analysis of endometrial proteome could lead to new ways of adenomyosis treatment.