Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis
Adenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on in vitro fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities...
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Frontiers Media S.A.
2024-12-01
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| Series: | Frontiers in Reproductive Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/frph.2024.1484202/full |
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| author | Gaby Moawad Youssef Youssef Arrigo Fruscalzo Slim Khedhri Hani Faysal Paul Pirtea Benedetta Guani Alexandre Vallée Jean Marc Ayoubi Anis Feki |
| author_facet | Gaby Moawad Youssef Youssef Arrigo Fruscalzo Slim Khedhri Hani Faysal Paul Pirtea Benedetta Guani Alexandre Vallée Jean Marc Ayoubi Anis Feki |
| author_sort | Gaby Moawad |
| collection | DOAJ |
| description | Adenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on in vitro fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities have been used to improve pregnancy rates and live birth outcomes; however, because of a lack of high-quality evidence, there is no clear consensus on the best pretreatment option. This review was conducted through a PubMed search aiming to highlight the relationship between pretreatment and fertility in women with adenomyosis. Medical, ablative surgical, and non-surgical therapies were reviewed. According to the current literature, gonadotropin-releasing hormone agonist therapy and placement of a levonorgestrel intrauterine system are two suitable medical pretreatment strategies that can improve the clinical pregnancy rates of patients with adenomyosis. Surgical ablation of adenomyosis can also be beneficial, although surgical management can be challenging. Non-surgical thermal techniques, including high-intensity focused ultrasound ablation, percutaneous microwave ablation, and radiofrequency ablation, are much less invasive techniques that have shown effectiveness in improving fertility. Although evidence remains limited, all these procedures have demonstrated a favourable safety profile. Further studies are needed to better develop these techniques and demonstrate their effectiveness. |
| format | Article |
| id | doaj-art-9751ed7c94d94e828e2e29a84d0b4c81 |
| institution | Kabale University |
| issn | 2673-3153 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Reproductive Health |
| spelling | doaj-art-9751ed7c94d94e828e2e29a84d0b4c812024-12-09T06:28:33ZengFrontiers Media S.A.Frontiers in Reproductive Health2673-31532024-12-01610.3389/frph.2024.14842021484202Effects of pretreatment strategies on fertility outcomes in patients with adenomyosisGaby Moawad0Youssef Youssef1Arrigo Fruscalzo2Slim Khedhri3Hani Faysal4Paul Pirtea5Benedetta Guani6Alexandre Vallée7Jean Marc Ayoubi8Anis Feki9Department of Obstetrics and Gynaecology, The George Washington University Hospital, Washington, DC, United StatesDivison of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, NY, United StatesDepartment of Obstetrics and Gynaecology, Fribourg University Hospital, Fribourg, SwitzerlandDepartment of Obstetrics and Gynaecology, Fribourg University Hospital, Fribourg, SwitzerlandDepartment of Obstetrics and Gynaecology, Indiana University, Indianapolis, IN, United StatesDepartment of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch–Faculté de Médecine Paris, Suresnes, FranceDepartment of Obstetrics and Gynaecology, Fribourg University Hospital, Fribourg, SwitzerlandDepartment of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch–Faculté de Médecine Paris, Suresnes, FranceDepartment of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch–Faculté de Médecine Paris, Suresnes, FranceDepartment of Obstetrics and Gynaecology, Fribourg University Hospital, Fribourg, SwitzerlandAdenomyosis is a commonly encountered pathology in women of reproductive age and frequently coexists with infertility. The effect of adenomyosis on fertility, particularly on in vitro fertilisation and intracytoplasmic sperm injection outcomes, is not well understood. Various pretreatment modalities have been used to improve pregnancy rates and live birth outcomes; however, because of a lack of high-quality evidence, there is no clear consensus on the best pretreatment option. This review was conducted through a PubMed search aiming to highlight the relationship between pretreatment and fertility in women with adenomyosis. Medical, ablative surgical, and non-surgical therapies were reviewed. According to the current literature, gonadotropin-releasing hormone agonist therapy and placement of a levonorgestrel intrauterine system are two suitable medical pretreatment strategies that can improve the clinical pregnancy rates of patients with adenomyosis. Surgical ablation of adenomyosis can also be beneficial, although surgical management can be challenging. Non-surgical thermal techniques, including high-intensity focused ultrasound ablation, percutaneous microwave ablation, and radiofrequency ablation, are much less invasive techniques that have shown effectiveness in improving fertility. Although evidence remains limited, all these procedures have demonstrated a favourable safety profile. Further studies are needed to better develop these techniques and demonstrate their effectiveness.https://www.frontiersin.org/articles/10.3389/frph.2024.1484202/fulladenomyosispregnancyinfertilityin vitro fertilisationgonadotropin-releasing hormone agonistlevonorgestrel intrauterine system |
| spellingShingle | Gaby Moawad Youssef Youssef Arrigo Fruscalzo Slim Khedhri Hani Faysal Paul Pirtea Benedetta Guani Alexandre Vallée Jean Marc Ayoubi Anis Feki Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis Frontiers in Reproductive Health adenomyosis pregnancy infertility in vitro fertilisation gonadotropin-releasing hormone agonist levonorgestrel intrauterine system |
| title | Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis |
| title_full | Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis |
| title_fullStr | Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis |
| title_full_unstemmed | Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis |
| title_short | Effects of pretreatment strategies on fertility outcomes in patients with adenomyosis |
| title_sort | effects of pretreatment strategies on fertility outcomes in patients with adenomyosis |
| topic | adenomyosis pregnancy infertility in vitro fertilisation gonadotropin-releasing hormone agonist levonorgestrel intrauterine system |
| url | https://www.frontiersin.org/articles/10.3389/frph.2024.1484202/full |
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