"Adenomyosis"

Perturbations of the endometrial immune microenvironment in endometriosis and adenomyosis: their impact on reproduction and pregnancy. The impact of endometriosis and adenomyosis on reproduction and pregnancy is significant, with both conditions linked to increased rates of infertility, poor ovarian function in women with endometriosis, and elevated pregnancy complications in those endometrium in these adverse effects. Emerging evidence indicates substantial differences in endometrial NK cells, macrophages, and T cells, leading to inflammatory responses in women with endometriosis and adenomyosis. These alterations may contribute not only to disease progression but also to defective endometrial receptivity, insufficient angiogenesis remodeling, impaired maternal-fetal immune tolerance

Natural history of endometriosis in pregnancy: ultrasound study of morphology of deep endometriosis and ovarian endometrioma. To assess the morphological appearance of deep endometriosis and ovarian endometrioma in pregnancy using pelvic ultrasound examination METHODS: This was a prospective observational cohort study conducted over three years at a single centre. We included 65 women women were included in the study. Their median age was 34 years (23-44), and the gestation at presentation was 7+6 weeks (3+6 to 18+0). 47/65 (72%) were nulliparous, 48/65 (74%) had a background of endometriosis and 19/65 (29%) conceived following IVF. There were 10/65 (15%, 95% CI 7-24) women with endometrioma alone, 28/65 (43%, 95% CI 31-55) with nodules alone and the remaining 27/65 (42%, 95% CI 30

Quality of life and symptoms of pain in patients with endometriomas compared to those with other endometriosis lesions: a cross-sectional study. Endometriomas are genetically distinct from other endometriosis lesions and could be associated with a predisposition to excessive inflammation. However, differences in clinical presentation between types of endometriosis lesions have not been fully elucidated. This study aimed to investigate the quality of life and pain scores of patients with endometriomas compared to those with other types of endometriosis lesions. A cross-sectional observational study was conducted between January 2020 and August 2023. Patients diagnosed with endometriosis completed the Endometriosis Health Profile 30 pain subscale questionnaire for their quality of life score

Endometrioma patients are under-treated with endocrine endometriosis therapy. Is there a difference in the use of endocrine endometriosis therapy in endometriosis patients with and without endometrioma? Patients with endometriomas received significantly less endocrine endometriosis treatment (present intake in 42.5%) compared to patients with other forms of endometriosis and without endometriomas (present intake in 52.1%). Endocrine endometriosis therapy in patients with endometriomas reduces the risk of recurrence and therefore the risk of further surgery and subsequent irreversible damage to ovaries which results into reduced antral follicle counts (AFC), anti-Mullerian hormone levels (AMH), and early menopause. However, there is evidence of increasing rejection of endocrine

A rare case of concomitant endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrial deep endometriosis. Carcinomatous changes from the ectopic endometrial glands in endometriosis have been reported in many studies, but malignant transformation from uterine adenomyosis/adenomyoma is rare. And clear cell-like adenocarcinoma represents a seldom changes of the original deep endometriosis.The patient underwent subsequent transabdominal tumor cell reduction surgery and chemotherapy. We herein present a rare case of combined endometrioid adenocarcinoma arising from uterine adenomyosis and clear cell carcinoma arising from parametrial deep endometriosis that may help inspire additional studies in the future. The patient underwent robot-assisted

Progesterone levels do not differ between patients with or without endometriosis/adenomyosis both in those who conceive after hormone replacement therapy-frozen embryo transfer cycles and those who do not. Do women with endometriosis who achieve a live birth (LB) after HRT-frozen embryo transfer (HRT-FET) have different progesterone levels on the day of transfer compared to unaffected women was based on published imaging criteria (transvaginal sonography/magnetic resonance imaging) and/or confirmed histology. The primary outcome was progesterone levels on the day of the HRT-FET leading to a LB in patients with endometriosis compared to unaffected women. Subgroup analyses were performed based on the presence of deep infiltrating endometriosis or adenomyosis. A total of 1784 patients were

Evaluating the development of endometriosis and adenomyosis lesions over time: An ultrasound study of symptomatic women. There is a gap in knowledge regarding development of endometriosis and adenomyosis lesions visible at transvaginal ultrasound. The objectives were to evaluate if women with symptoms suggestive of endometriosis or adenomyosis but normal ultrasound examination develop endometriosis or adenomyosis lesions visible at ultrasound over time and if alterations of symptoms over time are associated with ultrasound findings at follow-up. This was a prospective cohort study of 100 symptomatic women with normal initial ultrasound examination during 2014-2017 who underwent follow-up ultrasound examination in 2022. Symptoms suggestive of endometriosis were assessed using visual analog

Gene expression profiles separate endometriosis lesion subtypes and indicate a sensitivity of endometrioma to estrogen suppressive treatments through elevated ESR2 expression. Endometriosis is a common, gynaecological disease characterised by the presence of endometrial-like cells growing outside the uterus. Lesions appear at multiple locations, present with variation in appearance, size and their ability to respond is conflicting. A variation in their expression, activation of transcriptional co-regulators and the potential to respond may contribute to their variation in patient outcomes. Identifying patients who would benefit from hormonal treatments remain an important goal in endometriosis research. Using gene expression data from endometriosis lesions including endometrioma (OMA, n = 28

Effect of catheter-directed ethanol sclerotherapy on ovarian reserve in patients with recurrent endometrioma: comparative analysis with primary endometriosis. Catheter-directed ethanol sclerotherapy (CDS) is known to less affect the ovarian function, with comparable efficacy. This study aims to investigate the change in ovarian reserve after catheter-directed ethanol sclerotherapy in patients with recurrent endometrioma, as compared to primary endometrioma. Retrospective, observational study. Electronic medical records and images of patients with endometrioma who underwent CDS from August 2014 to April 2022 at a single institution were obtained. Patients aged > 18 years old and with anti-Müllerian hormone (AMH) level between 0.8 and 10.0 with regular menstruation were enrolled. Cyst diameter

Various types of adenomyosis and endometriosis: In search of optimal management. Currently, the mainstay for treating endometriosis/adenomyosis consists in hormonal drugs. Aside from staying within the "therapeutic window" and cutting off the hormonal support to the ectopic endometrium, none of these treatments were developed with a pre-identified target. The current lack of innovation is humbling, especially considering that among over 34,000 PubMed-indexed publications on endometriosis or adenomyosis, ∼65% of them were published in the last two decades, many of them presumably with all the benefits of omics and molecular biology. One major reason for so many doomed research and development (R&D) projects on non-hormonal drugs is the failure to understand the natural history

Proposal for targeted, neo-evolutionary-oriented secondary prevention of early-onset endometriosis and adenomyosis. Part II: medical interventions. According to consistent epidemiological data, the slope of the incidence curve of endometriosis rises rapidly and sharply around the age of 25 years. The delay in diagnosis is generally reported to be between 5 and 8 years in adult women , but it appears to be over 10 years in adolescents. If this is true, the actual onset of endometriosis in many young women would be chronologically placed in the early postmenarchal years. Ovulation and menstruation are inflammatory events that, when occurring repeatedly for years, may theoretically favour the early development of endometriosis and adenomyosis. Moreover, repeated acute dysmenorrhoea episodes

Endometriosis and adenomyosis: shared pathophysiology. Endometriosis and adenomyosis are closely related disorders. Their pathophysiologies are extremely similar. Both tissues originate from eutopically located intracavitary endometrium. Oligoclones of endometrial glandular epithelial cells with somatic mutations and attached stromal cells may give rise to endometriosis if they travel epithelial cells, whereas the adenomyotic epithelial cells almost exclusively bear KRAS mutations. Epigenetic abnormalities in the stromal cells of endometriosis and adenomyosis are very similar and involve abnormal expression of nuclear receptors including the steroid receptors. These epigenetic defects give rise to excessive local estrogen biosynthesis by aromatase and abnormal estrogen action via

ENDOMETRIAL RECEPTIVITY IN ADENOMYOSIS AND/OR ENDOMETRIOSIS. A narrative review on endometrial receptivity in adenomyosis and/or endometriosis reveals that this parameter is difficult to assess in natural conception, as both disorders alter natural fertility. Recent data emanating from ART have allowed to study endometrial receptivity in women affected by adenomyosis and endometriosis. This has upended our views on the effects of these two disorders on embryo implantation. Today, the very existence of altered receptivity in ART is questioned. In this context, we now know that frozen euploid blastocyst transfers in E2 and progesterone cycles have unaltered outcome in case of both adenomyosis and endometriosis.

ASSOCIATION OF ENDOMETRIOSIS AND ADENOMYOSIS WITH PREGNANCY AND INFERTILITY. We performed a comprehensive narrative synthesis of systematic reviews with meta-analysis published in the last five years on the association of endometriosis and adenomyosis with reproductive and obstetric outcomes. The aim was defining the information on which to base preconceptional counselling and clarifying whether and in which cases pregnant women with endometriosis and adenomyosis should be referred to tertiary care centers and followed as high-risk obstetric patients. Reduced pregnancy and live birth rates, and an increased miscarriage rate were observed in women with endometriosis and adenomyosis. The effect was larger in women with adenomyosis than in those with endometriosis. Women with superficial peritoneal

Proposal for targeted, neo-evolutionary-oriented, secondary prevention of early-onset endometriosis and adenomyosis. Part I: pathogenic aspects. The potential for repeated ovulation and menstruation is thought to have provided a Darwinian advantage during the Palaeolithic. Reproductive conditions remained relatively stable until the pre-industrial era, characterized by late menarche, very young of ovulatory menstruations, such as endometriosis and adenomyosis. The incidence of endometriosis shows a steep and progressive increase around the age of 25 years, but given the consistently reported delay in diagnosis, the actual incidence curve should be shifted to the left, supporting the possibility that the disease has its roots in adolescence. This raises the question of whether, from an evolutionary

Endometriosis and adenomyosis in the crosshair: variants of one disorder or fortuitous coincidence. Adenomyosis and endometriosis share a common origin as both of them result from the development of endometrial tissue outside the endometrium. Despite this, the 2 disorders were until recently considered as 2 different entities notably, because of their different epidemiology. Today, however, new

Birmingham UK DisclosuresJG declares that he has no competing interests. * * Differentials * Leiomyomas (fibroids) * Endometriosis * Endometrial hyperplasia More Differentials * Guidelines * SOGC guideline no. 437: diagnosis and management of adenomyosis * Heavy menstrual bleeding: assessment and management More Guidelines * Patient information Painful periods Fertility problems: questions to ask your Adenomyosis Adenomyosis - Symptoms, diagnosis and treatment | BMJ Best PracticeSkip to main contentSkip to search * English (US)EnglishPortuguês * Log in * Personal account * Access through your institution(Open Athens) * Subscribe * Access through your institution * Log in * English (US)EnglishPortuguês HomeSearchSearchHome * About usOverviewWhat is BMJ Best Practice?Our historyKey

Prevalence of endometrioma and deep infiltrating endometriosis with transvaginal ultrasonographic examination of women with subfertility undergoing assisted reproductive treatment: a prospective cohort study. To estimate the prevalence of endometrioma and deep infiltrating endometriosis (DIE), assessed by systematic transvaginal ultrasound examination, in women with subfertility accepted December 2018 and May 2021. All women underwent a systematic transvaginal ultrasound examination. The endometriotic lesions visible on ultrasound examination were described according to the International Deep Endometriosis Analysis group consensus opinion for systematic approach to assess endometriotic lesions. Prevalence of endometrioma and DIE in women with subfertility and prevalence of endometriotic

, chronic pelvic pain, dyspareunia, dysuria, dyschezia) using a visual analog scale. Abnormal findings in the uterus, ovaries, bowel, urinary bladder, uterosacral ligaments, and rectovaginal septum were noted, and their size and location were described. Prevalence of endometriosis, adenomyosis, endometrioma, and deep endometriosis in different anatomical locations was reported. Prevalence of ovarian endometrioma and/or deep endometriosis was 25% and of adenomyosis was 12%. Prevalence of endometrioma was 20% and of deep endometriosis was 9%, for each location being 8% in the bowel, 3% in the uterosacral ligaments, 3% in the rectovaginal septum and 0.5% in the urinary bladder. In symptomatic women examined with transvaginal ultrasound by an experienced ultrasound examiner, ovarian endometrioma and/or deep

Patients' and relatives' perspectives on best possible care in the context of developing a multidisciplinary center for endometriosis and adenomyosis: findings from a national survey. Endometriosis and adenomyosis are common benign conditions compromising both physical and psychological health, with a negative impact on quality of life. This survey aimed to establish what the users' perspectives are on best possible care in the context of developing a multidisciplinary center for endometriosis and adenomyosis in Norway. An electronic questionnaire was developed in collaboration between the Norwegian Patient's Endometriosis Society (NPES) and gynecologists with special interest in endometriosis and adenomyosis. The questionnaire was distributed digitally to the members of NPES in May 2021. 938