Adenomyosis
predicts impaired uterotubal transport in endometriosis
Researchers reveal that
many endometriosis patients, particularly those with
concomitant adenomyosis, have their uterotubal transport
impeded by hyperperistalsis or dysperistalsis
Stefan Kissler, who led the research team at the Johann-Wolfgang-Goethe
University at Frankfurt-am-Mainn in Germany, explains
that the extent of the adenomyotic component in women
with endometriosis explains much of the reduced fertility
in women with intact tubo-ovarian anatomy.
Hyperperistalsis and dysperistalsis of the uterus are
already known to be common in endometriosis patients
and thought to contribute to their poor fertility. The
researchers therefore set out to establish whether these
phenomena are caused by endometriosis itself or the
adenomyotic component of the disease.
Of the 41 endometriosis patients included in the study,
35 showed evidence of adenomyosis on T2-weighted magnetic
resonance imaging. Further examination of the patients
with hysterosalpingography showed that that two (33
percent) of the six with no adenomyosis had dysperistalsis
and hyperperistalsis, compared with 14 (58 percent)
of the 24 with focal adenomyosis and 10 (91 percent)
of the 11 with diffuse adenomyosis.
Wherease this is a relatively small study, the researchers
are able to propose that that "endometriosis is
associated with impeded hyperperistaltic and dysperistaltic
uterotubal transport capacity. However, adenomyosis
is of even more importance, especially when diffuse
adenomyosis is detected."
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