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REVIEW article

Front. Reprod. Health
Sec. Assisted Reproduction
Volume 6 - 2024 | doi: 10.3389/frph.2024.1484202

Effects of Pretreatment Strategies on Fertility Outcomes in Patients with Adenomyosis

Provisionally accepted
Gaby Moawad Gaby Moawad 1*Youssef Youssef Youssef Youssef 2*Arrigo Fruscalzo Arrigo Fruscalzo 3Slim Khedhri Slim Khedhri 3*Hani Faysal Hani Faysal 4*Paul PIRTEA Paul PIRTEA 5Benedetta Guani Benedetta Guani 3*Alexandre Vallée Alexandre Vallée 5*Jean Marc bernard Ayoubi Jean Marc bernard Ayoubi 5Anis Feki Anis Feki 3*
  • 1 1. Department of Obstetrics and Gynaecology, The George Washington University Hospital,, Washington, United States
  • 2 2. Department of Obstetrics and Gynaecology, Hurley Medical Center/Michigan State University College of Human Medicine, Flint, United States
  • 3 Fribourg University Hospital, Fribourg, Switzerland
  • 4 4. Department of Obstetrics and Gynaecology, Indiana University, Indianapolis, United States
  • 5 Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Foch, 92150 Suresnes, France, Suresnes, France

The final, formatted version of the article will be published soon.

    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.

    Keywords: Adenomyosis, Pregnancy, Infertility, In vitro fertilisation, gonadotropin-releasing hormone agonist, Levonorgestrel intrauterine system, Surgery, High-intensity focused ultrasound

    Received: 21 Aug 2024; Accepted: 14 Oct 2024.

    Copyright: © 2024 Moawad, Youssef, Fruscalzo, Khedhri, Faysal, PIRTEA, Guani, Vallée, Ayoubi and Feki. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Gaby Moawad, 1. Department of Obstetrics and Gynaecology, The George Washington University Hospital,, Washington, United States
    Youssef Youssef, 2. Department of Obstetrics and Gynaecology, Hurley Medical Center/Michigan State University College of Human Medicine, Flint, United States
    Slim Khedhri, Fribourg University Hospital, Fribourg, Switzerland
    Hani Faysal, 4. Department of Obstetrics and Gynaecology, Indiana University, Indianapolis, United States
    Benedetta Guani, Fribourg University Hospital, Fribourg, Switzerland
    Alexandre Vallée, Department of Obstetrics and Gynecology and Reproductive Medicine, Hôpital Foch, 92150 Suresnes, France, Suresnes, France
    Anis Feki, Fribourg University Hospital, Fribourg, Switzerland

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.