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Adenomyosis and uterine fibroids: treatment and impact on fertility
Hlinecká, Kristýna ; Bláha, Jan (advisor) ; Pilka, Radovan (referee) ; Hudeček, Robert (referee)
Introduction In times of postponing the first pregnancy into the fourth or even fifth decade, there is a growing demand for fertility-saving procedures for these uterine diseases. As women age, fertility generally declines. The etiology of both diseases, as well as their relationship to infertility, remains uncertain. The prevalence of fibroids and adenomyosis is around 30 and 20 %. Treatment methods vary from pharmacological to surgical. In this study, we tried to compare two groups of patients with different types of fertility-sparing uterine surgeries and evaluate their reproductive outcomes. While myomectomy (the control group) can be considered a well-established procedure with standardized surgical steps and predictable fertility outcomes, resection of severe adenomyosis represents a newer and more controversial alternative to conservative therapy. Methods Patients of reproductive age with focal or diffuse adenomyosis who are planning pregnancy were included in the study. The diagnosis was performed ultrasonographically. Between 2004 and 2019, a total of 110 women underwent laparoscopic or open uterus-sparing surgery for clinically significant uterine adenomyosis (group A), diffuse adenomyosis (group AD), or fibroids (group B). Results Two groups of women who underwent different...
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