Features of planning and course of pregnancy in adenomyosis. Adenomyosis: is pregnancy possible with this pathology? Adenomyosis and pregnancy is it possible to get pregnant

Often, adenomyosis and pregnancy entail serious consequences; approaching the issue of conception, having a similar diagnosis, should be gradual. Adenomyosis is commonly called. First of all, this is a process in which the female organs begin to suffer due to the appearance of an infection, various foci appear in the tissues or ovaries, which are similar in structure to the uterine mucosa.

A little about the disease itself

As a rule, it is difficult to confuse another disease with adenomyosis. It occurs in women of reproductive age, approximately 18 to 35 years of age. The risk group includes girls and women who have previously had abortions or miscarriages. There is also a possibility of infection in women who underwent gynecological operations. In some cases, the disease can be caused by hard work or various stressful situations. But the disease can occur even if such cases did not occur.

Adenomyosis is a disease that is difficult to treat. It is advisable to take a course of medication before a planned pregnancy in order to avoid negative consequences. As mentioned earlier, the effect of the drug is effective if the recommendations are fully followed, and normal gestation is possible in the first stages of the disease.

Adenomyosis and childbearing are two concepts that should not be compatible in any way. The disease becomes the main problem of women who want to get pregnant. Some patients have high levels of estrogen, and this provokes the appearance of adenomyosis. This is followed by infertility. After the age of 40, women's estrogen levels begin to drop, so they are less likely to be diagnosed with the problem.

What are the chances of becoming a mother with an ailment

As a rule, a number of negative consequences are associated with adenomyosis, primarily infertility. What is the difficulty of conception:

• Due to the violation of the fallopian tubes caused by the disease, the egg is not able to enter the uterus;
• Lack of ovulation due to hormonal failure;
• Reactions that occur in the female body, disrupt sperm motility, participate in the process of fertilization;
• Sexual intercourse is accompanied by pain, so intimacy occurs irregularly;
• The risk of miscarriage increases, as the muscular layer of the uterus is constantly contracting and an inflammatory process occurs in it.

Important! It is possible to become pregnant with such a disease only if treatment is completed that will restore the basic functions of the female body for bearing a child. How effective the medication will be depends on the complexity of the disease and the prescribed procedures. The probability of being cured increases significantly if the patient's disease lasts no longer than three years.

How to get rid of the consequences of the disease

If you are afraid that the disease will cause your infertility, you should regularly undergo gynecological examinations by a specialist, at least once a year. If you have any complaints, do not postpone going to the doctor. Provided that the problem is identified in time, you can undergo a course of treatment, which will allow you to become pregnant and safely endure the unborn child.

As a rule, the first and second stages respond well to treatment. The first stage may be accompanied by relapses, especially if the patient has an extremely unstable hormonal background. Then it is difficult to talk about a complete cure. To prevent the disease from interfering with your ideas for planning a pregnancy, you should follow all the recommendations of your doctor and in no case self-medicate.

At the third and fourth stages, almost 85% of the women who applied hear a disappointing diagnosis - infertility. Under this condition, the most reliable method of treatment is considered a possible option for surgical intervention. When an operation is performed, doctors try to remove diseased uterine tissue in an attempt to preserve the organ, provided it can be done. Already at the fourth stage, it is impossible to simply get rid of the affected tissue. You have to remove the uterus and the ovaries themselves.

How is the bearing of a child, provided that you have been diagnosed

If you still managed to get pregnant with this disease, this is a great success. But, nevertheless, there is a risk. Pregnancy is easier in the first stage of the disease.

Which had a pronounced character during the onset of pregnancy, subside. But do not relax. This does not mean that the problems have receded. After the birth of the child, with the onset of the first menstruation, they will come again. Provided that you were able to become pregnant with such a diagnosis, you should try to save the pregnancy, since there is often a threat of miscarriage. Abortion in this case can cause an early relapse, which will subsequently affect the health and condition not in the best way.

Staying in position can also play a positive role in the recovery process. A woman's body goes through menopause. It continues for some time, most often about six months. During this time, there is an inhibition of the processes occurring in the tissues of endometriosis. In other words, the problem recedes.

What examination can the doctor prescribe

When such a disease appears, it is worthwhile to postpone pregnancy planning for a while, since the disease can be very unpredictable. There are two main types of treatment:

The first option brings the state of hormones within the normal range, and helps maintain the immune system. The number of medications and the duration of treatment are determined individually, based on the general condition of the patient and the severity of the disease. In addition, specialists will pay attention to the age of the woman, and rely on her desire to bear a healthy child. There is a possibility that taking certain medications may be accompanied by severe pain, in which case doctors can prescribe special non-steroidal drugs that will have anti-inflammatory effects.

At the time of prescribing drugs, specialists mainly act with extreme caution, comprehensively studying each patient so that the selection of certain medications does not affect the woman in the worst way. The main tasks of therapeutic treatment are to stop the occurrence of foci that provoke the mucous membrane and cause the uterus to contract. For such purposes, it is recommended to take progestogens or androgens. The choice of dosage and the drug itself should be chosen by the attending physician.

In pregnant patients, the threat of miscarriage must be prevented in order to protect the patient from such an unpleasant consequence as the loss of a child. First of all, doctors try to do everything possible in order to save the pregnancy. In most patients, pregnancy develops as the disease progresses. Therefore, doctors try to strengthen the mother's immunity by taking special drugs. Your doctor may additionally prescribe some of these types of medications:

• Drugs that relieve spasms and pain. These include: Spazgan, No-shpa, Papaverine;
• Some sedatives;
• Medicines that normalize the work of digestion, for example, Gastal.

The use of any other medicines or procedures is highly undesirable, as it can harm the fetus. The medical staff is responsible for the treatment of patients, therefore, first of all, they try not to aggravate the situation by prescribing drugs that can negatively affect both the health of the mother and the child herself.

Herbal preparations and infusions to relieve symptoms

Some doctors recommend combining medication with herbal remedies, or just some types of herbs. A very good way to get rid of pain is a compress, which includes white clay. It is recommended to apply it to the lower abdomen, since clay tends to relieve pain. You can use various decoctions and infusions. Herbal douching also has the ability to relieve pain. This treatment is considered safe. A decoction for douching consists of the following varieties of herbs:

• marigolds;
• nettle leaves;
• Eucalyptus;
• Peony;
• yarrow;
• Oak bark and bergenia root.

You need to take a small amount of each herb in equal proportions, pour into a bowl and brew with boiling water. Then you need to insist the broth for several hours, then strain and use it for douching. If the procedure is not very suitable for you, and there is intolerance to certain types of herbs, you can prepare a decoction for oral administration. For this you will need:

• Celandine;
• Plantain;
• birch buds;
• Juniper;
• Poplar fruits.

This decoction will help the maturation of the egg, so you can get pregnant. You will find detailed instructions for preparing a decoction by visiting any forum. Now there is a large selection of different types of herbal preparations that help get rid of some of the symptoms, or at least relieve discomfort.

Girls have many options for getting to know the disease and its consequences: for example, the Internet. A large number of women and girls of various ages visit the forum, where they tell their stories of adenomyosis, and the secrets of a miraculous recovery and successful pregnancy. From them you can get useful information that will surely come in handy. For example, find a recipe for an herbal tincture in order to reduce the duration of menstruation, which causes great problems for some patients.

Do not forget about the main methods of treatment. Qualified specialists will help you and select the most effective drugs. It is worth adhering to the recommendations of medical personnel and contacting in a timely manner in case of any health problems. The main thing is to diagnose the problem in time and find the best solution. We wish you health and prosperity.

The mucous cavity of the uterus can grow an unlimited number of times under the influence of the hormonal system. This mechanism is important when pregnancy occurs. So she prepares to accept the egg, fertilized by the sperm, to allow it to infiltrate the uterine wall. If pregnancy does not occur in a particular cycle, then the endometrium, which lines the inner walls of the female organ, is rejected, and comes out through the vagina in the form of menstrual discharge.

In order to understand whether it is possible or not to become pregnant with uterine adenomyosis, you need to understand the features of the course of the pathology. In short, adenomyosis is a diagnosis that means that the tissues of the endometrium of the uterus grow beyond its cavity, penetrate deep into the walls of the organ.

Sometimes it happens that endometrial cells penetrate into the peritoneum. The reasons for this are various:

• operations,
• internal injury,
• reflux of menstrual blood, etc.

In this case, the cells no longer take root on the surface of the uterus, but on the membranes of other organs, which provokes the development of inflammatory foci. Meanwhile, the endometrium grows into the uterine walls, into the walls of other internal organs, significantly disrupting their functioning.

Diagnosis means infertility?

The statistics are disappointing. In 40-80% of cases, it is adenomyosis that causes infertility in women. But it is important to remember something else: competent treatment will help you get pregnant in the end, even in severe cases. And sometimes pregnancy occurs without the help of a gynecologist. However, it is not worth hoping for this, especially after the age of 35, nulliparous.

For favorable gestation and delivery, doctors recommend first curing adenomyosis, and only then planning a pregnancy. With an undesirable outcome, the disease of the uterus will only progress, and rapidly, and give complications.

So, the question of whether it is possible to get pregnant with adenomyosis does not have a definite answer. One thing is clear: there are much fewer opportunities for conception than for an absolutely healthy woman, but there are chances. If you still managed to get pregnant, then the gestation process is constantly under threat of interruption.

Is it possible to get pregnant and endure with adenomyosis? The problem requires a detailed explanation. Why is fertilization not possible?

1. Adenomyosis is a disease in which the walls of the uterus are affected by pathological growths, often spreading to nearby organs. If the fallopian tubes are damaged, then conception is impossible. Due to the inflammatory process, adhesions form inside the pipes, making it difficult to pass.
2. Hormonal balance is disturbed. Because of this, the reproductive system does not work like clockwork. Failures occur, in particular, in the processes of maturation of the egg. This is expressed in the fact that a woman notices menstrual disorders: irregularity, prolonged and heavy periods, accompanied by painful sensations, daubs at the beginning and end of menstrual bleeding, etc.
3. Against the background of adenomyosis, the immune system is depressed. The female body perceives spermatozoa that have reached the uterine cavity as threatening agents and seeks to neutralize them. The same "fate" can befall the formed embryo. Damage and rejection occurs at an early stage, when implantation has not even occurred. Pregnancy with adenomyosis can end at a very early stage.
4. The uterus is characterized by increased contractility, exceeding the norm. Because of this, even if conception has occurred, the fertilized egg is embedded in the uterine wall, there is a risk of rejection of the fetal egg.
5. Adenomyosis and the chances of pregnancy after 40 years - one might say, are incompatible concepts. The probability is 50 to 50. Not only is the functioning of the female organs gradually slowing down at this age, there may also be other gynecological diseases. These are ovarian cysts, uterine fibroids, chronic inflammation in the sex glands, etc.

Now it is worth evaluating not only the physiological, but also the psychological aspect. With adenomyosis, sexual life can be greatly complicated. In addition to pain during intercourse, many women experience a depressed state, they do not have a positive general mood, there is no or severely reduced libido. The less frequent the meetings, the less chance of conception.

Oddly enough, but adenomyosis with a disturbed hormonal balance, increased contractile activity of the muscular tissue of the uterus is not always a 100% guarantee that pregnancy will not occur. But if it happened, then all these manifestations of the pathological process are one of the main risk factors that can lead to miscarriage.

Unwanted consequences of a miscarriage

Pregnancy with adenomyosis of the uterus is extremely important to save. Otherwise, when interrupted, there is a high chance of a strong relapse of the disease, often it develops into a severe form.

The specifics of the postpartum period

The period after childbirth in a woman with such a diagnosis as adenomyosis is considered quite dangerous. At this time, there is a risk of relapse and accelerated development of the disease, while there will be bleeding. After childbirth, the female body is restored, the menstrual cycle resumes, which provokes the growth of the endometrium of the uterus. But this does not mean that if it turned out to become pregnant with such a diagnosis, it is worth interrupting it. Abortion, spontaneous or artificial, only worsens the condition of the uterus.

Help doctor

For those who decide to get pregnant with adenomyosis, if this does not happen without the help of a doctor, there are still ways. For example, your doctor may prescribe appropriate birth control. After the abolition of oral contraceptives, pregnancy may occur.

Sometimes other hormonal agents are prescribed, such as Utrozhestan, Duphaston, Byzanne, etc. (strictly in agreement with the doctor!). With obstruction of the fallopian tubes, laparoscopy, hysteroscopy may be recommended.

Adenomyosis and pregnancy

Adenomyosis can be cured after pregnancy. If adenomyosis is at an early stage, a woman is less than 35 years old, then pregnancy can really become a kind of cure. There is no menstrual bleeding during this period. There is a so-called physiological menopause, during which the growth of the endometrium and its pathological growth also slow down.

The specifics of the course of pregnancy in adenomyosis

1. It is likely that a woman with such a diagnosis has a progesterone deficiency. And this means that the contractility of the uterus is high, there is a risk of miscarriage, the danger of damage in the late term. A caesarean section will likely be required.
2. Sometimes there are adhesions in the uterine cavity with adenomyosis. Because of them, the growth of the fetus is difficult, it is forced to take the wrong position, which also makes it impossible to give birth naturally.
3. If there is a focus of adenomyosis near the place of attachment, there is a risk of premature detachment of the placenta.
4. Due to the pathological process in the vessels that deliver nutrients to the fetal membranes, there is a high risk of damage to them. This causes placental insufficiency, which can hinder the development of the child.

Control at all stages: from preparation for conception to gestation and delivery - a guarantee that a happy pregnancy with such a diagnosis is still possible.

Pregnancy with adenomyosis, if the disease is treated in a timely manner and the normal state of the organs of the reproductive system is maintained, is quite possible. Pregnancy can become the factor that will prevent the further development of the pathological process due to hormonal changes in the body. Whether pregnancy is possible with such a female disease depends on the degree of development of the pathology, the depth of the spread of foci inside the soft structures of the organs.

Adenomyosis in itself is not an obstacle to the successful conception and bearing of a child. It is not possible to get pregnant due to dysfunction of the genital organs due to their defeat by foci of the pathological process.

Adenomyosis and successful pregnancy are mutually exclusive for the following reasons:

• damage to the foci of the fallopian tubes with a violation of their contractile function, as a result of which the egg cannot enter the uterine cavity;
• autoimmune pathologies in the female reproductive system, in which antibodies are produced that destroy spermatozoa;
• lack of regular sex life due to the fact that sex causes severe pain.

Is it possible to get pregnant with adenomyosis of the uterus? Fertilization is possible only in cases where the disease is at the first stage of development and the foci have not yet had time to affect the internal organs, or complex treatment of complications of adenomyosis has been carried out.

Stages of the disease and the ability to give birth

Depending on the severity of the clinical case, the intensity of the symptomatic picture and the depth of ingrowth of the foci of the pathological process into the soft structures of the organs of the reproductive system, adenomyosis is divided into 4 stages. Each of them is characterized by its probability of conception.

The first and second stages - there are no complications in the state and functioning of the organs of the reproductive system, successful conception is possible. Adenomyosis of the 1st degree, even if a woman does not have pronounced symptoms of the disease, has a tendency to develop rapidly and relapse. Therefore, treatment based on maintenance therapy must be carried out without fail, despite the fact that women with such a diagnosis have successfully carried and given birth to a child.

Adenomyosis of the 3rd and 4th stages leads to total damage to the organ, the hormonal background is disturbed, pathological foci close the passage in the fallopian tubes. With adenomyosis of the uterus of grades 3 and 4, pregnancy is excluded, and the woman is diagnosed with persistent infertility.

At the third stage of the development of the pathological process, if the patient regularly conducts maintenance therapy, it is possible to become pregnant through the procedure of in vitro fertilization (IVF).

But IVF is not always the first time can give a positive result. During pregnancy, there is a high risk of complications, so you need to constantly be under the supervision of doctors.

When asked by patients whether it is possible to get pregnant with diagnosed stage 4 adenomyosis, the doctor answers unequivocally - no, in this case IVF will not help either. At this stage of the development of the pathological process, the only treatment is surgery, during which the woman can remove the uterus and ovaries.

Features of the course of pregnancy

Adenomyosis of the uterus and pregnancy can be combined in some cases. At stages 1-2 of the development of pathology, women successfully give birth, but the period of expectation of a child does not always go smoothly. Before you become pregnant with adenomyosis, you must undergo a thorough medical examination, according to the results of which the doctor will recommend a natural conception or an IVF procedure.

This disease, although it is treatable in the early stages of development, there is one “but” - the risks of relapse are always high. Regardless of the gestational age, the uterus, affected by pathological foci, may suddenly begin to contract, which is why there is a high probability of miscarriage. It is possible to get pregnant in this condition of the uterus, but the pregnancy should proceed under the constant supervision of doctors.

Such precautions are necessary, because due to the spread of foci, the walls of the uterine cavity become excessively compacted, and this can cause rejection of the amniotic egg. This happens at any time. With adenomyosis, you can lose a baby in the 1st trimester, when the amniotic egg is rejected and a miscarriage occurs, and at a later date, for example, in the 3rd trimester, a sudden contraction of the walls of the uterus can cause premature birth.

It is believed that it is quite possible to cure this pathology during pregnancy, since due to the natural restructuring of the hormonal background, the foci of the pathological process will stop developing and will gradually decrease in size.

But there is another side of the disease. Due to the fact that the pregnant woman's hormonal background, disturbed due to the development of pathology, is changing, the ovaries cannot produce enough of the pregnancy hormone - progesterone. As a result of this condition, uterine hypertonicity occurs. If therapy is not carried out in a timely manner, constant hypertonicity will cause spontaneous abortion.

Those women who became pregnant with adenomyosis say that the pregnancy proceeded with complications, and fetal hypoxia was most often diagnosed. The lack of oxygen is caused by the fact that the foci of the pathological process can develop locally in the uterine cavity, leading to impaired blood circulation. As a result, the fetus cannot receive a sufficient amount of nutrients and oxygen through the placenta, and therefore anomalies in the development of the child may occur.

The theory that adenomyosis is curable with pregnancy has a medical basis. But a cure is possible only if adenomyosis was found before pregnancy and appropriately treated. If the pregnancy proceeded normally, there were no complications, then under the influence of a changed hormonal background, the foci cease to develop. When breastfeeding, when there is no menstruation for a long period, it happens that the foci of adenomyosis disappear completely.

In vitro fertilization in pathology

In order not to lead to the aggravation of the pathological condition, adenomyosis must be diagnosed in time. Due to the absence of a symptomatic picture in the early stages of the development of the disease, adenomyosis in most cases is determined by chance during a preventive examination by a gynecologist. In this regard, doctors do not stop telling women: take the time to visit the gynecologist twice a year.

If the disease has worsened and complications have begun, it is almost impossible to get pregnant naturally. In such cases, the IVF procedure gives hope. Also, when adenomyosis is diagnosed, and a woman is planning a pregnancy after 40 years, only IVF is suitable.

Before in vitro fertilization is carried out directly, long-term and complex therapy is prescribed. The patient will need to take hormonal drugs. The essence of such treatment is to introduce the reproductive system into a state of artificial menopause. The ovaries get a rest, the size and number of foci of pathology decreases. After the abolition of hormonal treatment, the likelihood of successful fertilization increases.

But IVF is not a panacea. Even artificial insemination for stage 3 adenomyosis is not always successful. The absence of a positive result can be caused by a total lesion of the muscle layer of the uterine cavity - the myometrium, which makes it impossible for the process of fixing the amniotic egg.

Sometimes the pathology is manifested by pain in the lower abdomen before menstruation and during intercourse, as well as excessively abundant discharge during menstruation.

Read about other symptoms of adenomyosis.

This disease can affect not only the genital area, but also spread to other organs nearby.

Unfortunately, adenomyosis is the most common cause of female infertility.

Is it possible to get pregnant?

Polycystic ovaries is a disease in which ovulation does not occur due to the presence of multiple follicular cysts in each ovary that do not mature to the dominant level.

One of the alleged causes of this disease is considered a hormonal disorder in the body, namely an increased level of the male hormone in the female body.

In addition, hereditary predisposition can also influence the development of polycystic disease. This disease occupies one of the first places among the causes of infertility in women of childbearing age.

Polycystic ovaries are treated in a variety of ways.

If the patient does not plan the next pregnancy, then treatment should begin with oral contraceptives, the action of which will be aimed at reducing the content of male hormones (androgens, progesterone) in the woman's body.

The result of effective treatment can be the normalization of the menstrual cycle, the onset of ovulation, and subsequently a long-awaited pregnancy.

If this method of treatment is unsuccessful, then surgical intervention will be required.. It is necessary to perform a resection of the ovaries, which can be performed by an open or laparoscopic method.

After such an operation, the probability of pregnancy increases to 65%.

However, in case of negative results within 6 months after the operation, an examination should be carried out to identify other causes of infertility.

“Adenomyosis is directly related to the reproductive function of women, as it can lead to increased uterine tone. The presence of endometrial tissue in inappropriate muscular layers of the uterus can lead to rejection of the embryo in early pregnancy or to termination of pregnancy at different times. This means that it is quite possible to become pregnant with adenomyosis, but there will be a constant risk of termination of pregnancy. But it should be noted that adenomyosis is not always the cause of infertility. The inflammation caused by this disease often causes adhesions that make it difficult to pass and conception itself. In any case, the treatment is selected individually and empirically.

Is conception dangerous?

More than 70% of women diagnosed with adenomyosis cannot conceive.

This is prevented by many reasons, for example, one of them is that the presence of foreign cells in the uterus causes it to contract more often, thereby rejecting the embryo.

In addition, the patency of the fallopian tubes decreases, which prevents the fertilization of the egg.

Even if this happens, the pregnancy cannot proceed normally and without complications. Such a diagnosis during pregnancy involves regular visits to the antenatal clinic and constant monitoring by the attending physician.

It is necessary to monitor the condition of the uterus, placenta and fetus at different times.

In the early stages of pregnancy, it is necessary to monitor the development of the placenta, which is responsible for metabolism and controls many processes.

At the same time, hormonal support and close monitoring of the placenta are important for a woman.. In the second trimester, pain may occur, which also needs to be controlled and monitored.

In addition, an malpresentation of the fetus is often diagnosed, therefore, in most cases, a caesarean section is prescribed for delivery.

How does it affect the course of pregnancy?

At forms of adenomyosis, pregnancy occurs without problems, and sometimes a woman may not even be aware of the presence of the disease.

But in more severe forms of pathology, there are a number of factors that prevent pregnancy.

One of the main problems during conception can be a violation of the cycle in a woman.

Irregular menstruation makes it difficult to determine the date of ovulation. Therefore, in these cases, women are forced to resort to special tests or temperature indicators.

There is also such an obstacle as adhesions, which do not allow spermatozoa to penetrate through the tubes inside..

To eliminate this problem, you can perform a special operation to remove adhesions in the uterine cavity.

However, this operation does not give a long-term result, so you should act immediately - the disease can resume at any time.

CAREFULLY!

In case of successful fertilization, there are some threats to terminate the pregnancy.

As mentioned above, hormone therapy is very effective in maintaining pregnancy. However, in more severe cases, it is possible to increase the tone of the uterus, which can lead to miscarriage.

To prevent such complications, it is necessary to consult a doctor in advance and plan a pregnancy.

The doctor will help prescribe the appropriate treatment in advance, which will prepare the uterus for bearing and the smooth course of pregnancy.

It must be remembered that in mild forms of pathology, adenomyosis is not a contraindication or an obstacle to pregnancy.

With successful conception, pregnancy and childbirth, adenomyosis may even recede. The main thing is to diagnose the disease in time and start treatment.

Sometimes adenomyosis may disappear completely after delivery..

This is due to the fact that pregnancy is a kind of menopause, during which the endometrial cells stop growing, which means that a woman can get rid of the pathology.

IVF for illness

In most cases, when examining women suffering from infertility, adenomyosis is diagnosed.

Most often, the disease is not the only cause of infertility, but the likelihood of a successful pregnancy is reduced.

A positive IVF result in this pathology is 40-60%. This indicator is very high, so do not despair, but continue trying to conceive a child and treatment.

The indications for the appointment of IVF for adenomyosis include the following::

• lack of results of all previous treatments;
• adhesive processes in the pelvic area, which can be very dangerous for other organs;
• lack of ovulation, which is associated with hormonal disorders and increased levels of prolactin;
• immune disorders that can lead to the death of spermatozoa and the impossibility of attaching the embryo to the uterine wall.

For a successful IVF procedure, a woman needs to prepare her body and undergo an appropriate course of treatment.

With the help of treatment, it is necessary to restore the hormonal background and increase the patency of the fallopian tubes.

IVF can be prescribed only after undergoing hormone therapy.

Diagnostic measures

One of the most effective methods for detecting adenomyosis is ultrasound..

For a more accurate diagnosis, it is necessary to undergo an examination by a gynecologist.

Usually this procedure consists in examining the genitals with the help of mirrors, taking smears, and also examining the cervix with the help of special magnifying devices.

It is also necessary to undergo a general examination of all organs by various specialists to exclude other accompanying diagnoses.

In addition, you need to pass a number of tests that may be necessary for a possible surgical intervention.

Treatment Methods

If you want to get pregnant, then it is better to first be examined by a specialist.

If a pathology is detected, the conception of a child should be delayed.

The course of the disease is unpredictable, and a possible pregnancy can lead to various unpleasant consequences.

After passing, it is worth waiting a few months and only then proceed to conception. The disease may recede, or it may manifest itself with renewed vigor.

In this case, hormone therapy or drug treatment against inflammation can be prescribed..

The greatest threat of abortion can occur in the 1st trimester, the rest of the pregnancy depends on the success of this period.

Can there be infertility?

Usually, the causes of infertility may not be the disease itself, but the pathologies that develop on its basis and together can lead to childlessness.

It is especially common in women with advanced pathologies that should be treated immediately..

One way to solve this problem is surgery, thanks to which many women can become pregnant.

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Evaluation of a drug or treatment

Adenomyosis is a disease in which the mucous layer of the uterus - the endometrium - grows into the muscle layer - the myometrium. Pathology is manifested by prolonged and profuse menstrual bleeding, accompanied by soreness. Adenomyosis can be congenital, but most often occurs in reproductive age due to hormonal disorders. In this regard, the problems of reproduction begin from the moment of fertilization.

The entire period of pregnancy, a woman needs specialized monitoring and supportive care. During childbirth, there is a high risk of complications, up to heavy bleeding with subsequent removal of the uterus.

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Reproductive system in adenomyosis

The reproductive system of a woman depends on many structural, hormonal and biochemical processes. Violation of any link can lead to infertility. In adenomyosis, the problem is often diffuse (not localized) and presents with multiple pathological changes. Of fundamental importance is the duration and prevalence of the disease.

The uterus plays a key role in the process of bearing a child. It is represented by three layers: mucous, muscular and serous. The inner layer lining the organ cavity is the endometrium. Under the condition of a physiological menstrual cycle and the absence of pregnancy, it is rejected every month, the woman sees it in the form of bleeding.

The regulation of the menstrual cycle and the frequency of endometrial rejection are carried out by hormones. They are produced in the ovaries, pituitary gland and other endocrine organs. With the development of pathological conditions in the body, uncontrolled germination of the endometrium into the muscular layer of the uterus occurs, and therefore its regular and physiological rejection is disturbed.

Unilateral adenomyosis

Germination of the endometrium can be local or diffuse. In the first case, a limited area of ​​\u200b\u200bthe muscle layer is affected, in the second, most of the endometrium is tightly connected to the myometrium. The volume of growth is determined in the process of diagnosis, the appointment of therapeutic manipulations and the tactics of planning and managing pregnancy fundamentally depend on this.



Symptoms of pathology

Some experts believe that adenomyosis is the initial stage of endometriosis, while others distinguish it as a separate disease. At an early stage of development, both pathologies have similar signs and clinical symptoms.

Among the main manifestations of adenomyosis, the following symptoms are distinguished:

• the duration of the menstrual cycle decreases;
• menstruation lasts more than 5 days, at the beginning and end they differ in blood smearing;
• a woman feels constant discomfort in the pelvic cavity;
• pains are intense and pronounced from the moment of premenstrual syndrome and until the end of menstruation;
• bleeding is profuse, which often leads to anemia.

Women of reproductive age are subject to mandatory examination in order to identify the true cause of adenomyosis, since many pathological conditions are related, the development of an oncological process is not excluded.



Causes of the disease

The etiology of adenomyosis is not fully understood. There is an assumption that the disease is provoked by hormonal disorders - an excess of estrogen. Contribute to the germination of the endometrium multiple births and abortions. In some women, the pathology is due to a genetic predisposition.

Often the disease is discovered by chance during a preventive examination or planning a pregnancy. However, it has not been possible to establish the root cause.

Provoking factors include:

• uncontrolled intake of combined oral contraceptives;
• neoplasms of the ovaries and pituitary gland, provoking hormonal dysfunction;
• multiple and complicated childbirth;
• surgical interventions on the uterus and pelvic organs;
• sudden weight gain or weight loss;
• physical overstrain with increased intra-abdominal pressure.

When conducting a comprehensive examination, several causes that contribute to adenomyosis are often identified at once. The greatest danger is represented by tumor formations of hormone-producing organs, which have a malignant course and are difficult to treat, causing irreversible consequences.



Adenomyosis and pregnancy

The possibility of fertilization, childbearing and physiological childbirth depends on the severity and type of the pathological process. For each specific condition, individual therapeutic tactics will be required, which is based on the features of the development of the disorder.

Degree/form of adenomyosis	Development mechanism	Impact on pregnancy
I degree	Germination of the endometrium is limited to the basal layer. Clinical manifestations are rare	With rational drug correction, pregnancy proceeds naturally, without complications.
II degree	The endometrium reaches the middle of the muscle layer	Throughout pregnancy, women are at risk of interruption, a special regimen and additional dynamic monitoring are needed.
III degree	Mucous sprouts through the muscle thickness and reaches the serous layer	A pronounced hormonal imbalance disrupts the menstrual cycle and impedes the process of fertilization, the possibility of miscarriage is not ruled out throughout pregnancy, and spontaneous bleeding often develops. During delivery, he uses the tactics of caesarean section, it is not excluded the complete removal of the uterus
IV degree	The pathological process passes through the serous layer and spreads to nearby organs	The possibility of pregnancy is difficult, women face difficulties even during the conception period, infertility often develops
Focal form	It develops as nodes or cysts, does not exceed 10% of the total number of cases of adenomyosis. Cavity formations have inclusions in the form of a brown liquid that accumulates as a result of menstruation	The prognosis of the course of pregnancy is usually favorable, especially if the nodes and the attached placenta are located on different walls of the uterus
diffuse form	The most common form of adenomyosis occurs in 2/3 of all cases. The pathological process is spread over the entire surface of the muscle layer, multiple fistulas are formed in the pelvic cavity and adhesions	The adhesive process often becomes an obstacle in the way of the spermatozoon, but even under the condition of fertilization, the zygote cannot fully gain a foothold on the mucous layer. Spontaneous abortion develops already in the first trimester

The earlier the diagnosis is made and adenomyosis is detected, the more favorable the process of pregnancy development and the less complications in the postpartum period. The main danger posed by pathology for women of reproductive age is the development of persistent infertility.

Fertilization

The main problem that women face with adenomyosis appears even at the time of conception. Given that the disease often occurs with hormonal imbalance, the duration of the menstrual cycle and the nature of the discharge are disturbed. For most women, the cycle becomes irregular, and it is not possible to reliably determine ovulation at home.

To calculate the most favorable days for conception, a woman needs to calculate ovulation for several months using the calendar method using marks on the onset of menstruation, conduct special tests and, if necessary, visit an ultrasound diagnostic room, which is the most informative of all possible methods.

Implantation

The next problem that arises in the development of pregnancy after fertilization has occurred is the impossibility of implantation. The fetus must attach to the endometrium, from where it will receive the necessary nutrition. Difficulties with implantation occur mainly in cases of a common pathological process.

If the mucous layer is severely damaged or the embryo is rejected by it, then pregnancy does not occur after fertilization. But this is due to the short life of one zygote. The next time you try to get pregnant, the situation can be radically different, so the diagnosis of infertility in this case is practically not made.

gestation

In most cases, pregnancy proceeds calmly, especially with nodal forms of the 1st and 2nd severity. To prevent premature delivery from the beginning of gestation, a woman is prescribed maintenance and corrective hormone therapy. The patient is shown sexual rest, limitation of physical and psycho-emotional overload, home regimen, especially in the first trimester.

At the 3rd, 4th degree of adenomyosis, when the process is diffuse and widespread, involving the entire muscle layer, the uterus is almost always in a state of tone, the risk of spontaneous abortion is always present. If fertilization and implantation did occur and a woman has the opportunity to bear a child, she spends most of her time in a hospital where specialized therapy is carried out.

Childbirth and the postpartum period

The tactics of delivery and observation in the postpartum period are completely dependent on the degree and form of the pathological process.

If adenomyosis is nodular in nature and the degree of its spread is insignificant, then it is recommended to carry out natural childbirth. But the situation changes when the attached placenta is in close proximity to adenomatous nodes, the risk of bleeding increases, the patient is under round-the-clock observation in the hospital for a longer period of time.

With diffuse spread of adenomyosis, the muscle layer is thin, there is a risk of uterine rupture during the period of attempts, difficulties arise with the physiological separation of the placenta, and the likelihood of bleeding is very high. A woman is prepared for childbirth in advance, often a week before the expected date she is hospitalized in a hospital.

Risk of infertility

A diagnosis of adenomyosis increases the risk of infertility. The disease occurs against the background of dyshormonal disorders, which in themselves may be incompatible with pregnancy. The endometrium not only grows into the deep layers, but also undergoes hypertrophy and changes that can interfere with pregnancy. The muscular layer of the uterus reacts to the introduction of thickening and restructuring, which prevents the bearing of the fetus.

On the other hand, if adenomyosis is detected at an early stage, it is recommended to give birth to a child if the pregnancy was planned. In the process of bearing the fetus, the hormonal background changes and there is no monthly rejection of the endometrium, and therefore the disease regresses. Sometimes after the birth of a child, it disappears completely, without any additional intervention.

Treatment

Therapy for adenomyosis depends on its severity and the age of the patient. Due to frequent systematic preventive examinations of the female population, neglected cases are quite rare. Therefore, conservative treatment is usually sufficient, with the help of which it is possible to achieve a complete recovery or a stable remission of the disease.

In the early stages of development, medications are prescribed, such as:

• oral contraceptives;
• non-steroidal anti-inflammatory drugs;
• analogues of gonadotropin-releasing hormone - Duphaston;
• analgesics;
• hemostatic and some other means.

Only a specialist can determine the number of necessary drugs, the duration of the course and dosage after conducting a comprehensive examination and identifying the degree and form of the disease. Given that the pathology is serious, self-medication is not recommended. With the development of severe forms, changes can be irreversible, resulting in infertility.

In the absence of a positive effect from the used tablet preparations, local therapy is indicated. For 1-3 years, a Mirena intrauterine device is installed for a woman, which contains hormones that normalize the growth of the endometrium. The active substance comes out in doses, so there is no risk of overdose or other contraindications.



Intrauterine device in the uterine cavity

In severe cases of the disease and resistance to conservative therapy, diagnostic hysteroscopy is performed, during which a biopsy specimen (biomaterial) is taken to study and exclude the oncological process. A clear indication for the complete removal of the organ is diffuse adenomyosis of the 4th degree.