Uterine adenomyoma associated with infertility. A report of three cases.

Adenomyosis and its localized, tumorlike variant, the adenomyoma, usually afflict multiparous, perimenopausal women and are not considered to cause infertility. Three cases of adenomyoma occurred in young, infertile women. The adenomyoma was not deemed solely responsible for the infertility, although in two cases it could have been contributory. The preoperative diagnosis was leiomyoma, and adenomyoma was not even considered; it was recognized during "myomectomy" in one case. Adenomyoma should be included in the differential diagnosis of a localized uterine tumor in an infertile woman. This preoperative recognition allows the gynecologist to discuss the lesion with the patient, pointing out that the operation may be technically difficult and may result in incomplete removal or hysterectomy and that excision of the tumor may not cure her infertility. It also prepares the gynecologist for the technical problems that may arise intraoperatively. Additional cases of adenomyoma in infertile women need to be reported on before light is shed on its causal relationship to infertility as well as on its diagnosis and management.