endometriosis

Adenomyosis and your fertility

Adenomyosis and fertility: Princeton IVF blog

Adeno what?

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Most women have never heard of adenomyosis, but most gynecologists have, and it is a condition that may affect your chances of having a baby.


What is adenomyosis?

Adenomyosis is a disease where the glands that line the uterine cavity (the endometrium) are growing into the muscle of the uterus (the myometrium). In the past adenomyosis was considered a form of endometriosis, a disease in which the glands that normal grow in the endometrium grow outside of the uterus.

What are the symptoms of adenomyosis?

The symptoms of adenomyosis are similar to those of fibroids, painful and heavy periods. Not everyone with adenomyosis had symptoms though.

How is adenomyosis diagnosed?

In the past and sometimes still, adenomyosis was diagnosed when the tissue from a hysterectomy (removal of the uterus), usually done on someone who is thought to have fibroids, is examined in the laboratory. Sometimes, adenomyosis can be seen on ultrasound and can be seen even better on MRI.

Does adenomyosis affect fertility?

In the past, the answer was unclear. Recent research suggests that it may harmful to your fertility. Women undergoing with adenomyosis undergoing IVF had lower implantation rates, lower pregnancy rates, lower live birth rates and higher miscarriage rates.

How is adenomyosis treated?

Most adenomyosis is treated by hysterectomy, but this is not an option for fertility patients. There are newer experimental procedures such as ultrasound ablation, but it is not clear how safe and effective they are.

Tuberculosis and infertility

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Tuberculosis (TB) and Infertility

Just recently, we passed World Tuberculosis Day. If you are like most folks, you probably never even knew that such a day even existed. In fact, most doctors here in the US, including fertility doctors, don't pay much attention to tuberculosis anyhow and think of it as a disease of the past, not really much of an issue here at home. Certainly, tuberculosis is a disease that is uncommon here in 21st century America. But that is not necessarily true around the world.

Practicing here in New Jersey, we see patients who have moved here from all over the world, and particularly quite a few from India. TB is endemic in India where it has been estimated that 40 % or more of the population is affected. Many who have been infected with tuberculosis are not even aware of it. 

While we generally think of TB as respiratory disease, it can also affect the reproductive system. While here in the United States, it is very uncommon to see genital tuberculosis, that is not necessarily true in other countries. TB can infect and damage the fallopian tubes and the lining of the uterus resulting in infertility. While this is relatively uncommon, it seen by New Jersey fertility doctors and obgyns from time to time, though most are unaware that it is even a possibility. Many can be helped by modern technologies such as IVF.

It turns out after all there is a connection between World TB Day and the world of Reproductive Medicine. Its a reminder that not all of the diseases we though we have conquered have completely been defeated.