T Madani - Department of Endocrinology and Female Infertility, Reproduc-tive Biomedicine Research Center, Royan Institute for Reproduc-tive Biomedicine, ACECR, Tehran, Iran
F Ahmadi - Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
N Jahangiri - Department of Endocrinology and Female Infertility, Reproduc-tive Biomedicine Research Center, Royan Institute for Reproduc-tive Biomedicine, ACECR, Tehran, Iran
A Sanati - Department of Endocrinology and Female Infertility, Reproduc-tive Biomedicine Research Center, Royan Institute for Reproduc-tive Biomedicine, ACECR, Tehran, Iran

Background: This study was designed to use ultrasound imag-ing to determine adenomyosis prevalence in infertile women. Materials and Methods: This cross-sectional screening study included 963 eligible infertile women referring for the first time to the infertility clinic of Royan Institute between 2014 and 2017. The patients were referred for transvaginal ultrasound prior to initiating the treatment. Women who had vaginismus excluded from the study. Adenomyosis was diagnosed in pres-ence of enlarged globular uterine body, asymmetric uterine wall thickening, heterogeneous myometrial echotexture, small myometrial cysts/subendometrial cysts, Echogenic nodules or linear striations radiating. Patients were divided into groups of women with adenomyosis and without adenomysis.Results: The overall prevalence of adenomyosis was found to be 17.1%, of which 53.4% were severe adenomyosis. The mean age of participants was 29.9 ± 5.4 years (range 18 to 45 years). The prevalence of patients had concomitant fibroids and ovarian endometrioma were 21.8 % and 8.5 % respectively. The mean age was significantly higher in the adenomyosis group than in the non-adenomyosis group (32.1 ± 5.1 vs. 29.5 ± 5.3 years, P> 0.001). There were significant differences between groups in regards to cause of infertility and infertility type (P=0.004 and P<0.001 respectively). The presence of adenomyosis has been shown to be associated to ovarian endometrioma [8.5 % vs. 1.4 %; P<0.001)]. The results of the multivariate logistic regression analysis showed that the strongest predictors of adenomyosis were age (OR = 1.05, 95% CI = 1.01-1.09), cause of infertility (OR = 1.01, 95% CI = 1.03-1.23) and ovarian endometrioma (OR = 3.36, 95% CI = 1.74-6.50).Conclusion: Adenomyosis seems to be a clinical condition with a high prevalence that may affect the reproductive outcomes.

Prevalence, Adenomyosis, Infertility, Ultrasound Di-agnosis