Key takeaways
- What Is Adenomyosis
- What Signs May Be Associated With Adenomyosis
- Is Adenomyosis the Same as Endometriosis
- How Can Adenomyosis Affect Fertility
Overview
A diagnosis of adenomyosis can be confusing, particularly because it is less widely understood than conditions such as PCOS or endometriosis.
Some women have noticeable symptoms, while others discover adenomyosis during a fertility scan.
Adenomyosis may affect fertility for some women, but the diagnosis does not mean that natural pregnancy is impossible or that IVF will automatically be required.
What Is Adenomyosis?
Adenomyosis is a condition affecting the muscular wall of the uterus.
It is different from endometriosis, although the two conditions may sometimes occur together.
The effect varies. Some women experience difficult periods, while others have few or no obvious symptoms.
What Signs May Be Associated With Adenomyosis?
Possible signs include:
- Heavy periods
- Painful periods
- Pelvic discomfort
- A feeling of pressure
- Difficulty conceiving
- No noticeable symptoms
These symptoms can also occur for other reasons. The doctor will consider the complete history and scan findings before making a diagnosis.
Is Adenomyosis the Same as Endometriosis?
No.
Both conditions involve tissue similar to the lining of the uterus, but they affect different areas.
Adenomyosis affects the muscular wall of the uterus. Endometriosis is found outside the uterus.
A woman may have one condition, both or neither.
How Can Adenomyosis Affect Fertility?
The exact effect is different for every woman.
Adenomyosis may influence how well the uterus supports conception or pregnancy in some cases. However, it can be difficult to determine how much the condition contributes to one couple’s fertility problem.
Age, ovarian reserve, the fallopian tubes, sperm health and other conditions may be equally important.
Can You Conceive Naturally?
Yes.
Some women with adenomyosis conceive naturally. Others may need fertility support.
The chance depends on:
- Age
- How long you have been trying
- Ovarian reserve
- Ovulation
- Fallopian-tube health
- Sperm health
- Whether endometriosis or fibroids are also present
- Previous pregnancies or treatment
The diagnosis should never be interpreted alone.
How Is Adenomyosis Identified?
A doctor may suspect adenomyosis based on symptoms and imaging of the uterus.
The findings should be reviewed by a clinician experienced in fertility because the treatment plan may differ for someone actively trying to conceive.
Not every scan finding requires treatment.
Does Adenomyosis Mean IVF Is Necessary?
No.
A younger couple with otherwise reassuring fertility results may be advised to continue naturally or consider a simpler treatment.
IVF may be discussed when:
- Age makes time more important
- Another fertility factor is present
- Pregnancy has not happened after earlier treatment
- IVF is expected to provide a better opportunity
- The couple already requires IVF for another reason
The doctor should explain what IVF is expected to improve.
Can Adenomyosis Affect Embryo Transfer?
The condition of the uterus may be considered when planning an embryo transfer.
The fertility specialist may recommend a personalised transfer plan based on the scan, symptoms and previous treatment history.
Do not assume that every woman with adenomyosis requires the same preparation or additional medicines.
Is Treatment Always Needed Before Trying?
No.
Treatment may be considered when symptoms are significant or when the fertility specialist believes it could meaningfully improve the plan.
The decision should consider:
- Age
- Fertility goals
- Symptoms
- Scan findings
- Ovarian reserve
- Previous treatment
- Whether delaying conception is advisable
Ask what the recommended treatment is expected to achieve and how long it will delay trying.
Should Both Partners Be Evaluated?
Yes.
Adenomyosis may be present, but another fertility factor may also contribute.
The evaluation may still consider ovulation, ovarian reserve, the fallopian tubes and the male partner’s semen analysis.
Avoid allowing one diagnosis to become the explanation before both partners are assessed.
Questions to Ask Your Specialist
Consider asking:
- How certain is the diagnosis?
- Is adenomyosis likely to affect my fertility?
- Can we continue trying naturally?
- Are my fallopian tubes open?
- What is my ovarian reserve?
- Does my partner need a semen analysis?
- Is treatment needed before trying?
- What is the purpose of the proposed treatment?
- Is IUI suitable?
- Why is IVF being recommended?
- Will adenomyosis change the embryo-transfer plan?
Adenomyosis Does Not Decide the Outcome
Adenomyosis may influence fertility, but its effect is not identical for every woman.
Some women conceive naturally, while others benefit from fertility treatment. The most suitable path depends on the complete fertility picture rather than the diagnosis alone.
Understand the scan, evaluate both partners and ask how each recommendation is expected to improve your individual chance.