Answer from: Luciano Nardo, MD, MRCOG
As I mentioned, adenomyosis can affect pregnancy and can cause miscarriage and can affect the ability of an embryo implanting successfully into the uterus. Obviously depends on where the endometriosis is in relation to where the pregnancy is growing or where the embryo is located. So most women that have got adenomyosis and endometriosis as well, will have the prolonged down regulation protocol whereby this the the temporary menopause is induced in order to prepare the body prepare, the uterus, prepare the endometrium and try to make the treatment more successful.
Answer from: Ahmed Elgheriany, MRCOG, MD, MSc
What you can do if you have adenomyosis and you are looking for a baby, very recent study prove, that protocol very long or ultra long protocol of IVF is effective on adenomyosis because it will suppress this adenomyosis gland and basically you are given injection, depo injection that suppresses a gland from secreting hormone and then suppressing all these adenomyosis problems and toxins on the endometrium. Adenomyosis problems it’s not only the pain that’s happening from the adenomyosis, it’s also the toxic materials secreting from this adenomas gland inside the womb itself and could harm the embryo, you could harm the eggs itself or everything. So it needs to be suppressed for a long time. If we are using an ultralong protocol (could be three months, could be one month) according to the severity. The second recommendation after doing this protocol is to freeze all embryos and then transfer later on. When we transfer, there is a protocol that we are giving short separation by the same hormones that we suppress the gland before transferring the embryo and then put back the embryo, so this giving the embryo a very good chance to survive and it’s a very comparable success rate even with adenomyosis.
Answer from: Anu Chawla, MRCOG, MBBS, M.S., DNB
I prefer long down regulation protocol for adenomyosis. Before the IVF starts, depo lupron injections are given. It basically calms down the whole reproductive organs. In that process, it comes down the adenomyosis on the functional aspect also so, everything has one physical aspect of just the mere presence and then the functional aspect, the biochemical aspect so, at least that aspect is taken care of by giving this depo injection which is given once a month sometimes one or two or up to three months before the actual IVF is done. This injection will calm down the whole reproductive system and it improves the outcome in a rightly selected group of women. In cases of adenomyosis, I try to give the injection crosstab at least once before the IVF and also before the frozen embryo transfer, if we have the frozen embryos for this patient. This overall anti-inflammatory effect of this injection might help although it is not in the protocol for many units because the evidence is not enough yet but these are the two methods medical and the surgical for adenomyosis but it can be a massive challenge for the doctor as well as the patient because if at all the adenomyosis is pretty significant and the previous implantations have failed, then removing the adenomyosis in safe hands might help but this is an important and careful decision after proper discussion, with the discussion of the side effects or the complications involved because we are actually taking out the adrenal meiosis and re-stitch the uterus so, it needs time to heal back and it can be more traumatic in untrained hands because it doesn’t have a clear capsule so, the expertise of the surgeon becomes very crucial.
Can someone with adenomyosis do IVF?
How is adenomyosis treated in IVF? Does IVF make adenomyosis worse?
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