Adenomyosis is a non-cancerous uterine condition primarily characterized by progressively worsening dysmenorrhea, causing lower abdominal pain during menstruation. This condition can significantly impact a woman's quality of life, often requiring medical attention. Diagnostic methods, such as B-ultrasound examination, can reveal uterine enlargement, thickening of the uterine muscle layer, and uneven echoes, all indicative of uterine adenomyosis.

The underlying pathology of adenomyosis involves the endometrial tissue becoming embedded in the uterine muscle layer, leading to recurrent pain and discomfort. Menstrual cycles exacerbate this condition, causing pain due to trapped endometrial tissue. In some cases, severe pain may necessitate surgical interventions like uterine resection, while conservative approaches, such as the Mirena intrauterine device or traditional Chinese medicine treatment with Fuyan Pill, are available for symptom management.

Adenomyosis can also impact fertility through its effect on the fallopian tubes. As endometrial glands and stroma infiltrate the uterine muscle layer, they create lesions, which can eventually lead to tubal obstruction, causing infertility.

Treatment for adenomyosis generally involves medication and surgery, with the chosen approach tailored to the patient's symptoms, fertility goals, and overall health.

Can women with adenomyosis undergo in vitro fertilization (IVF)?

Yes, women with adenomyosis can explore IVF as a viable option for conceiving. There have been successful IVF cases among patients with adenomyosis. Before commencing an IVF cycle, patients should undergo comprehensive physical evaluations, allowing doctors to create customized treatment plans to optimize IVF success.

Adenomyosis may lead to increased uterine contractions, potentially affecting embryo implantation and, consequently, the IVF success rate. However, if natural conception is challenging due to adenomyosis, IVF can be a successful alternative, provided that ovarian function remains healthy, and hormone levels are normal. Both mild and moderate cases of adenomyosis can typically proceed with IVF without complications.

For older women with severe adenomyosis, the probability of successful IVF pregnancy depends on several factors:

1. Severe adenomyosis can negatively impact the uterine environment. In addition, as women age, ovarian function declines, potentially leading to lower egg quality. In such cases, psychological well-being can play a significant role, affecting hormonal balance and, ultimately, IVF success rates. For some, the chance of a successful pregnancy may be less than 10%.

2. Older women with severe adenomyosis, who receive treatment to improve uterine and ovarian function under a doctor's guidance, may enhance their IVF success rate. In such cases, the likelihood of pregnancy can reach approximately 15%. With a stable mental state, the success rate can increase to about 20%.

Precautions for Adenomyosis and IVF:

1. Emotional well-being is crucial: Maintaining a positive outlook is vital. Excessive stress and anxiety can affect hormonal balance, potentially hindering embryo implantation. A positive and cheerful attitude can help the immune system function optimally.

2. Maintain uterine warmth: It's essential to prevent the uterus from getting too cold, as it plays a pivotal role in embryo implantation. Exposure to cold environments and the use of cooling medications should be avoided.

3. Avoid strenuous physical activities during the IVF cycle: It's advisable to keep the body in a comfortable state and avoid physical exhaustion.

It's essential to consider pregnancy at an optimal reproductive age. If conception doesn't occur within a year of trying, seeking proactive treatment is advisable. Delaying IVF treatment until later years can increase the influence of age on fertility and IVF success rates, potentially leading to a lower likelihood of success.

Two key points to bear in mind when considering IVF:

1. Success is not guaranteed: IVF is not a certain solution, and outcomes can vary. It's essential to acknowledge that it is a process with potential challenges.

2. Be prepared for sacrifices: IVF treatments can have some impact on an individual's health. Being mentally prepared for these changes is crucial.

From a medical perspective, adenomyosis typically affects women between the ages of 30 and 50, but it can also occur in younger women, often associated with uterine cavity procedures. In line with a prevention-oriented philosophy, it's advisable to minimize procedures that may harm the uterus, maintain a healthy lifestyle, and prioritize self-care to reduce the risk of adenomyosis.