Hatem Abu Hashim1, Solafa Elaraby2, Ashraf A Fouda3, Mohamed El Rakhawy4. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura Dakahlia 35516, Egypt. Electronic address: hatem_ah@hotmail.com. 2. Department of Obstetrics and Gynecology, Mansoura General Hospital, Mansoura Dakahlia 35511, Egypt. 3. Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura Dakahlia 35516, Egypt. 4. Department of Diagnostic Radiology, Faculty of Medicine, Mansoura University, Mansoura Dakahlia 35516, Egypt.
Abstract
RESEARCH QUESTION: Adenomyosis has been reported in a high proportion (24.4%) of infertile women, but this may be over-representative. What is the exact prevalence of adenomyosis in an infertility clinic population? DESIGN: In this cross-sectional study, 320 infertile women ≤41 years of age attending the infertility clinic of a university teaching hospital were screened by two-dimensional transvaginal ultrasound (2D-TVS) to look for the sonographic markers of adenomyosis, with subsequent magnetic resonance imaging (MRI) if suspected. Additionally, the adenomyosis subtype (I-IV) was determined from MRI geography (Kishi classification). Comparisons between women with and without adenomyosis were carried out. RESULTS: Adenomyosis was found by 2D-TVS in 24 cases (7.5%) and confirmed by MRI in 21 (6.6%). The mean age of the group was 29.2 ± 4.7 years. The most frequently observed sonographic finding (58.3% of cases) was asymmetrical myometrial thickening. The majority of MRI-confirmed cases (85.7%) had diffuse adenomyosis. A significantly higher prevalence was found in women ≥40 compared with women <40 years old (40.0% versus 4.9%, respectively; P < 0.0001). Adenomyotic women had significantly higher mean age (32.7 ± 3.0 versus 28.6 ± 4.4 years; P < 0.00001), body mass index (31.3 ± 2.7 versus 28.7 ± 3.3 kg/m2; P < 0.0001), suffered more dysmenorrhoea (38% versus 17%; P = 0.02) and had more ovarian endometriomas (19% versus 6%; P = 0.03) than those without adenomyosis. CONCLUSION: The observed prevalence of adenomyosis detected de novo by 2D-TVS in a population of young infertile women (7.5%) should alert gynaecologists and ultrasonographers to look for the features of adenomyosis when scanning such patients.
RESEARCH QUESTION: Adenomyosis has been reported in a high proportion (24.4%) of infertile women, but this may be over-representative. What is the exact prevalence of adenomyosis in an infertility clinic population? DESIGN: In this cross-sectional study, 320 infertile women ≤41 years of age attending the infertility clinic of a university teaching hospital were screened by two-dimensional transvaginal ultrasound (2D-TVS) to look for the sonographic markers of adenomyosis, with subsequent magnetic resonance imaging (MRI) if suspected. Additionally, the adenomyosis subtype (I-IV) was determined from MRI geography (Kishi classification). Comparisons between women with and without adenomyosis were carried out. RESULTS:Adenomyosis was found by 2D-TVS in 24 cases (7.5%) and confirmed by MRI in 21 (6.6%). The mean age of the group was 29.2 ± 4.7 years. The most frequently observed sonographic finding (58.3% of cases) was asymmetrical myometrial thickening. The majority of MRI-confirmed cases (85.7%) had diffuse adenomyosis. A significantly higher prevalence was found in women ≥40 compared with women <40 years old (40.0% versus 4.9%, respectively; P < 0.0001). Adenomyotic women had significantly higher mean age (32.7 ± 3.0 versus 28.6 ± 4.4 years; P < 0.00001), body mass index (31.3 ± 2.7 versus 28.7 ± 3.3 kg/m2; P < 0.0001), suffered more dysmenorrhoea (38% versus 17%; P = 0.02) and had more ovarian endometriomas (19% versus 6%; P = 0.03) than those without adenomyosis. CONCLUSION: The observed prevalence of adenomyosis detected de novo by 2D-TVS in a population of young infertile women (7.5%) should alert gynaecologists and ultrasonographers to look for the features of adenomyosis when scanning such patients.
Authors: Gaby Moawad; Mira H Kheil; Jean Marc Ayoubi; Jordan S Klebanoff; Sara Rahman; Fady I Sharara Journal: J Assist Reprod Genet Date: 2022-03-28 Impact factor: 3.412
Authors: Bin He; Xiao-Ming Teng; Fan Hao; Mei Zhao; Zhi-Qin Chen; Kun-Ming Li; Qiang Yan Journal: Front Endocrinol (Lausanne) Date: 2022-07-22 Impact factor: 6.055