Does adenomyosis affect pregnancy?

Can I get pregnant with adenomyosis? Adenomyosis, which we usually call uterine fibroids, is a disease that occurs on the female endometrium. Because it occurs in the uterus, it will inevitably have a certain impact on pregnancy. It is very difficult to get pregnant with adenomyosis, but it does not mean that adenomyosis will definitely lead to female infertility. However, if the fetus grows larger after pregnancy, it will inevitably have a certain impact on the fetus and the woman herself.

Adenomyosis is a benign disease caused by the invasion of the endometrium into the myometrium. Pathologically, the myometrium is thickened, with island-like distribution of endometrial glands and stroma between the muscle walls, accompanied by hyperplasia of smooth muscle fibers. The main symptoms are dysmenorrhea, increased menstrual flow and enlarged uterus. Accompanied by diffuse proliferation of the uterine myometrium, it was previously called intrinsic endometriosis. Does adenomyosis affect pregnancy?

Experts say that adenomyosis has an important connection with female infertility, and many patients with adenomyosis are often unable to become pregnant.

【No clear certainty】

There is no definitive conclusion on whether adenomyosis causes infertility. Because adenomyosis is often combined with endometriosis, it is difficult to separate the causes of decreased fertility. The possible causes of infertility caused by adenomyosis include: combined with endometriosis, which causes adhesions in the lesion site and, in severe cases, obstruction of egg collection and transportation functions. At the same time, the autoimmune response caused by endometriosis affects sperm activity, etc.

The mechanism remains unclear

Does adenomyosis affect pregnancy? The mechanism of infertility and early miscarriage in patients with adenomyosis remains unclear, but nitric oxide and potential vasodilation may be involved. Recent studies have shown that the endometrial glandular epithelium synthesizes nitric oxide and produces vascular epithelial cells. Endometrial nitric oxide synthesis varies with the menstrual cycle, especially in the second trimester of pregnancy. Endometrial cells produce large amounts of nitrogen oxides that hinder fertilization and implantation. Even if implantation has occurred, the embryo is attacked by activated macrophages and T cells, leading to miscarriage.

[Severe adenomyosis can easily lead to infertility]

The most concerning issue regarding adenomyosis is whether it will affect fertility and lead to infertility. It is generally believed that severe adenomyosis, especially in patients with combined endometriosis, is prone to infertility. This type of patients have uterine hypertrophy and are prone to pelvic adhesions, which are not conducive to ovulation and embryo implantation, so the natural pregnancy rate is not high.