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- W2058953397 abstract "The clinical impact of adenomyosis on infertility is controversial. The aim of this study was to determine the effect of ultrasound-diagnosed adenomyosis on implantation rates with good quality embryos in women undergoing IVF. With IRB approval, all women undergoing fresh and frozen embryo transfers with good quality embryos (embryos at appropriate stage of development with minimal fragmentation) at Mayo Clinic, Rochester from January 2009 to December 2010 were included. Images from pre-IVF ultrasounds performed by the same ultrasonographer were reviewed independently by two physicians blinded to cycle outcome. Adenomyosis was diagnosed only when at least three of the five standard ultrasound criteria for the disease were present: myometrial cysts, heterogenous myometrium, globular/asymmetric uterus, indistinct endo-myometrial junction and liner striations. Women not meeting these criteria served as controls. Women with fibroids, recurrent miscarriage and smokers were excluded. Implantation rates were calculated and logistic regression models were used to adjust for confounders for outcome. This study was powered (ß= 80%) to detect a difference in implantation of 25%. Of the 205 women reviewed, 149 women met inclusion criteria; 57 women met ultrasound criteria for adenomyosis and 92 women served as controls. There was excellent interobserver agreement on diagnosis of adenomyosis (k= 0.87). There was no difference between groups in demographics.[table1] No difference was noted in implantation rates between the two groups, before and after adjustment for confounders, unadjusted OR= 1.15[95%CI 0.57-2.15], adjusted OR= 1.14 [95%CI 0.26-4.77]. Women with ultrasonographic features of adenomyosis did not have impaired implantation. Further research is needed to explore if there truly is no impact of adenomyosis on implantation or whether use of more sensitive methods for detection of adenomyosis would lead to different findings.Table 1Adenomyosis GroupControlsp-valueAge (years)*33.49 ± 4.533.69 ± 4.910.80BMI*26.08 ± 5.225.52 ± 5.30.53Day 3 FSH *7.24 ± 1.87.55 ± 2.20.37Antral Follicle Count*22.5 ± 13.822.78 ± 12.40.90Endometriosis°7(12.2)6(6.5)0.22Fresh Cycles°35(61.4)55(59.7)0.84Number of embryos transferred*2.09 ± 0.72.13 ± 0.60.70Uterine Volume (cm3)*55.26 ± 23.154.77 ± 34.90.92* = Mean ± SD° = Number (%age) Open table in a new tab" @default.
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- W2058953397 date "2012-03-01" @default.
- W2058953397 modified "2023-10-16" @default.
- W2058953397 title "Does Adenomyosis Impair Implantation? A Cohort Study" @default.
- W2058953397 doi "https://doi.org/10.1016/j.fertnstert.2012.01.082" @default.
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