A Debate on Surgical Intervention for Adenomyosis Prior to In-Vitro Fertilization

Fayek, Bahi; Barrett-Chan, Ella; Woolcott, Ella; Khalifa, Esraa A.; Bedaiwy, Mohamed A.

doi:10.21608/jrme.2025.368280.1036

A Debate on Surgical Intervention for Adenomyosis Prior to In-Vitro Fertilization

Document Type : Invited Articles

Authors

¹ Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada - Department of Obstetrics and Gynecology, Menoufia University, Menoufia, Egypt

² Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC, Canada

³ Division of Abdominal Radiology, Department of Radiology, University of British Columbia, Vancouver, BC, Canada - Department of Radiology, Menoufia University, Menoufia, Egypt

10.21608/jrme.2025.368280.1036

Abstract

Adenomyosis is a benign uterine disorder distinguished by the ectopic presence of endometrial glands and stroma within the myometrium. It affects around 20% of individuals of reproductive age. Adenomyosis commonly presents with abnormal uterine bleeding, dysmenorrhea, chronic pelvic pain, dyspareunia, and is associated with infertility. While the mechanisms linking adenomyosis to infertility remain unclear, several factors may contribute to impaired reproductive outcomes. Although hysterectomy is the standard surgical treatment for symptomatic adenomyosis, it is not a suitable option for patients desiring fertility preservation. Conservative surgical interventions for adenomyosis before in-vitro fertilization (IVF) aim to improve reproductive outcomes but carry inherent risks. The decision to pursue conservative surgery for adenomyosis remains a topic of debate, requiring careful consideration of potential benefits and surgical risks. Identifying optimal candidates for surgical intervention is crucial to maximizing benefits while minimizing complications. This article explores the debate surrounding conservative surgical intervention for adenomyosis prior to IVF.

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