Pathological proliferation of tissues in the reproductive organs is a common phenomenon that occurs in almost 30% of all patients. At the same time, almost all such processes can have a negative impact on the likelihood of the onset and successful pregnancy. How are adenomyosis and pregnancy, whether they can occur together, etc., described in this article.
Pregnancy with a diagnosis
Adenomyosis is a process of pathological proliferation of endometrial tissues when its cells divide excessively actively. And it is precisely to the endometrium that the embryo attaches at the onset of conception. Thus, it is clear why this disease affects the likelihood of pregnancy and childbearing.
Is it possible?
Pregnancy with adenomyosis of the uterus is possible, but the probability of its occurrence is quite low. It decreases depending on the degree of development of the disease, and when it remains almost unchanged in the first and second stages, even the infertility can be diagnosed in the third and fourth because of the large areas of lesions. However, the diagnosis of infertility is made quite rarely - only 30-40% of cases.
However, much depends on how old the patient is. Doctors identified the following pattern:
- Adenomyosis and pregnancy after 40 years almost never occur together. At this age, the probability of conception is the lowest. It is less than 50%
- The younger the patient, the higher the probability of conception with such a diagnosis,
- After 35 years of pregnancy with this diagnosis almost never occurs without hormone therapy or appropriate treatment,
- In adolescents with this pathology, the probability of conception is also very low.
Can I get pregnant with uterine adenomyosis? In most cases, more or less likely to succeed. However, why it is not worth doing this will be discussed below.
The consequences of miscarriage and abortion
Adenomyosis develops as a result of hormonal imbalance. Pregnancy is the strongest hormonal stress for the body, and its interruption, regardless of the reasons that caused it, is even greater. Therefore, if conception happened with this diagnosis, the child must be saved. Miscarriage or abortion in this case will lead to the strongest relapse of the disease or accelerate its development as a result of a hormonal jump.
At the same time, it is important to remember that with this diagnosis, it is extremely difficult to maintain a pregnancy, since it itself significantly increases the probability of spontaneous interruption.
Consequences of the disease for pregnancy
Adenomyosis of the uterus and pregnancy do not fit well together due to the fact that the very likelihood of conception is reduced. And even if it has come, the risk of miscarriage and the development of various pathologies that are dangerous both to the fetus and to the expectant mother are very high throughout the pregnancy. Still more complicated by the fact that with such a diagnosis it is extremely important to carry the child, since both abortion and miscarriage will only significantly worsen the condition of the woman, as mentioned above.
Why you should not get pregnant with this diagnosis?
- A high probability of missed abortion is present at all terms of gestation,
- In the first and second trimesters there is a high probability of miscarriage,
- Blood supply to the placenta is impaired.
- Most often there is abnormal placenta previa,
- Sometimes a child is diagnosed with oxygen starvation,
- Such a diagnosis is a potential indication for cesarean section, since vaginal delivery can cause cervical injury,
- There may be significant and difficult to stop bleeding after childbirth,
- Constantly maintained strong hypertonicity of the uterus.
For all these reasons, pregnancy in this period is extremely undesirable. In addition, with this diagnosis, the body does not need additional hormonal changes and fluctuations. But if the fertilization did occur, the doctors prescribe a therapy to preserve the fetus and successfully complete the pregnancy.
Pregnancy after treatment
A cured disease does not adversely affect the probability of pregnancy. If the treatment was carried out correctly, the infection did not join, and the adhesive process did not develop, then the subsequent conception will occur with the same probability as if the disease had not been in history.
- Women of younger and middle reproductive age become pregnant quickly and without any problems,
- Older women of reproductive age may also have children, but they sometimes need preparatory therapy,
- Women over 40-45 years old need preparatory and supportive therapy to ensure that conception and gestation take place safely.
In any case, when planning a child after such a disease, it is necessary to consult a doctor for consultation.
How to get pregnant with adenomyosis? It is not necessary to do this, since such a pregnancy, without additional supporting therapy, rarely ends safely. What dangers may exist in this case are described below. Therefore, you must first cure the disease itself. How to do it?
Therapy is carried out by medical or surgical methods. During surgical intervention, cauterization of tissue growth centers is carried out using a current, nitrogen or laser using a laparoscope. Another type of surgery is used only with strong degrees of development of the disease and only in women who have previously given birth. This is curettage of the endometrium.
Medicamentous therapy of this disease is carried out by hormonal drugs, since it is hormone-dependent. Prescribed, mainly, progesterone drugs, such as Vizanna, Duphaston, used on an individual scheme. Sometimes combined oral contraceptives are prescribed, one tablet per day for three to six months.
Another option is gonadotropin releasing hormone agonist therapy. This means Zoladex, Buserelin. They are prescribed in pills daily or one injection per month for up to six months.
Therapy to save pregnancy
Most often, women with adenomyosis have a significant progesterone deficiency. This is one of the female sex hormones, which, among other things, affects the contractility of the uterus, increasing it. It is the high contractile ability of the uterus that leads to the formation of hypertonus, which results in a high probability of miscarriage.
The main goal with such maintenance therapy is to preserve pregnancy and reduce the likelihood of miscarriage. For this, it is just necessary to lower the hypertonus of the uterus. This is done by increasing the content of progesterone in the blood. For this, patients are prescribed drugs:
- Urozhestan is taken 200-100 mg per day, while the daily dosage is recommended to be divided into two doses, and drink the medicine in the morning and evening,
- Duphaston is taken 2-3 times a day, with a single dose of 5-10 mg, and 20-30 mg daily. It is necessary to accept according to an individual scheme,
- Vizanna - progestogen drug, drunk one tablet per day.
Depending on the duration of pregnancy, the dosage of the drug can be adjusted by the doctor, for which reason the doctor should strictly prescribe such medicine. To self-medicate in this case is unacceptable, as it can threaten both the mother and the child.
Essence of pathology
The causes of this disease can be hormonal disorders, genetic predisposition or injuries of the uterus caused by operations or abortions.
In most cases, adenomyosis does not manifest itself and is detected only when examined by a gynecologist or after ultrasound.
Sometimes the pathology is manifested by pains in the lower abdomen before menstruation and during intercourse, as well as excessively abundant secretions during menstruation.
Read about other symptoms of adenomyosis here.
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 ovarian disease 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 level of the dominant.
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 affect the development of polycystic. This disease is one of the first places among the causes of infertility in women of childbearing age.
Polycystic ovaries are treated in various ways.
If the patient does not plan the next pregnancy, the treatment should be started 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 - the long-awaited pregnancy.
If this method of treatment was unsuccessful, then surgical intervention will be required.. It is necessary to resect the ovaries, which can be done in an open or laparoscopic manner.
After this operation, the probability of pregnancy increases to 65%..
However, if negative results occur within 6 months after surgery, an examination should be conducted to identify other causes of infertility.
Is conception dangerous?
More than 70% of women with adenomyosis cannot become pregnant..
This is hampered by many reasons, for example, one of them - 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 is reduced, which prevents fertilization of the egg.
Even if this happens, 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 state 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 the metabolism and controls many processes.
At the same time, hormonal support and close observation of the placenta are important for women.. In the second trimester, you may experience pain, which also needs to be monitored and monitored.
In addition, they often diagnose improper presentation of the fetus, therefore, in most cases, a cesarean section is prescribed for delivery.
How does it affect the course of pregnancy?
With elementary and simple forms of adenomyosis, pregnancy occurs without problems, and sometimes a woman may not even be aware of the presence of the disease.
But with more severe forms of pathology, there are a number of factors that prevent pregnancy.
One of the main problems at conception may 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 using special tests or temperature indicators.
There is also an obstacle such as adhesions that prevent sperm from penetrating through the tubes..
To eliminate this problem, you can conduct a special operation to remove adhesions in the uterus.
However, this operation does not give a long-term result, therefore, it is necessary to act immediately - the disease can resume at any time.
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, you should consult with your doctor in advance and plan pregnancy..
The doctor will help you prescribe the appropriate treatment in advance, which will be the preparation of the uterus for pregnancy and the smooth course of pregnancy.
It must be remembered that in milder forms of pathology adenomyosis is not a contraindication or an obstacle to pregnancy..
With successful conception, pregnancy and childbirth, adenomyosis can even retreat. The main thing - time to diagnose the disease and start treatment.
Sometimes after birth, adenomyosis can completely disappear..
This is explained by 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 with the disease
In most cases, the examination of women suffering from infertility diagnosed adenomyosis disease.
Most often, the disease is not the only cause of infertility, but the probability of a successful pregnancy is reduced.
Doctors may recommend IVF - in vitro fertilization. But for the success of this procedure, it is necessary to conduct proper treatment and bring the body in order.
IVF is usually recommended in cases where other treatments and fertilization have been rendered useless.
A positive IVF result for this pathology is 40-60%. This indicator is very high, so do not despair, but continue to try to conceive a child and treatment.
The indications of IVF for adenomyosis include the following:
- lack of results from all previous treatments,
- adhesions in the pelvic area, which can be very dangerous for other organs,
- lack of ovulation, which is associated with hormonal disorders and an increased content of prolactin,
- immunity disorders, which can lead to the death of spermatozoa and the impossibility of attaching the embryo to the wall of the uterus.
For a successful IVF procedure, a woman needs to prepare her body and undergo an appropriate course of treatment..
With the help of treatment, you need to restore hormones and increase the patency of the fallopian tubes.
IVF can be prescribed only after passing hormone therapy.
One of the most effective methods for detecting adenomyosis is ultrasound.
For a more accurate diagnosis, you must be examined by a gynecologist.
Usually this procedure consists in the examination of the genital organs with the help of mirrors, the taking of smears, and also the examination of the cervix with the help of special magnifying devices.
In addition, you need to pass a series of tests that may be necessary for a possible surgical intervention.
If you want to get pregnant, then for this purpose it is better to have an examination with a specialist.
If you find a pathology with the conception of the child should be delayed.
The course of the disease is unpredictable, and possible pregnancy can lead to various unpleasant consequences..
After completing the course of treatment, it is worth waiting for several months and only then proceed to conceive. The disease can retreat, and can manifest itself with a new force.
At the same time, it is possible to prescribe a hormonal therapy or drug treatment against inflammation..
The greatest threat of termination of pregnancy can occur in the first trimester, the rest of the pregnancy depends on the success of the period.
Can there be infertility?
Usually, the cause of infertility may not be the disease itself, but the pathologies that develop on its soil and together can lead to childlessness.
It is especially common in women with advanced pathologies, which should be treated immediately..
One way to solve this problem is surgery, through which many women can become pregnant.
General description of the pathology
Adenomyosis is a disease of a benign nature, which is characterized by the germination of the inner layer of the uterus (endometrium) in the thickness of this organ. This is one of the varieties of endometriosis.
In case of adenomyosis, the endometrium penetrates only into the middle layer of the uterus, without involving other organs in the pathological process nearby. As a result of the changes that occur, the uterus increases in size, while its functionality is impaired.
The disease is quite common: it is diagnosed in 8-45% of cases. Such a run-up in indicators is explained by the frequent asymptomatic course of the pathological process. A feature of the pathology is its asymptomatic course and a tendency to relapse.
Most other adenomyosis are women aged 30 to 45 years, but the first symptoms of such a deviation may occur even in adolescence.
This disease often causes infertility in women. Adenomyosis and pregnancy are usually incompatible conditions. Тем не менее, иногда зачатие при таком диагнозе происходит, но в данном случае присутствует высокий риск самопроизвольного аборта.
Причины патологического процесса
Adenomyosis is a disease whose developmental mechanism and risk factors are not clearly defined. The most common opinion is that this pathological process develops under the influence of hormonal changes associated with disorders of the hypothalamic-pituitary-ovarian system.
The reasons that can cause the development of adenomyosis are the following:
- surgery in the area of the uterus,
- genetic disorders
- early or late puberty,
- heavy exercise
- prolonged and frequent exposure to the sun or ultraviolet rays, which is especially important for women under the age of 30 years,
- abortion earlier
- lack of sex life
- allergic diseases
- having bad habits
- a history of difficult childbirth, cesarean section,
- thyroid pathology,
- prolonged use of oral contraceptives
- sedentary lifestyle,
- reduced immunity
- too early sexual debut
- adverse effects on the body of environmental factors
- diseases of the gastrointestinal tract,
- prolonged use of uterine spirals to protect against unwanted pregnancy.
Diseases of the inflammatory and infectious nature, extending to the organs of the reproductive system, can also provoke the development of adenomyosis.
Doctors indicate that adenomyosis is caused by a hormonal factor: pathology develops in women of childbearing age and disappears after the onset of menopause, with the extinction of sexual functions and hormonal activity of the body.
Symptoms of adenomyosis
The disease for a long time may be asymptomatic, so it is usually detected in advanced stages.
Symptoms of pathology should include the following:
- violation of the menstrual cycle,
- long, heavy and painful menstruation, which lasts 7 days or more,
- in the menstrual blood clots are visible,
- intermenstrual uterine bleeding,
- bleeding, appearing a few days before the onset of menstruation,
- general weakness
- fainting and fainting
- sleep disorders
- pain in the lower abdomen, which may extend into the crotch or groin area,
- pain during sexual intercourse, which becomes more pronounced a few days before the onset of menstruation.
In pregnant women, adenomyosis is manifested in pain in the lower abdomen, which is aggravated by physical exertion, the release of blood or clear fluid from the genital tract.
If a woman suffering from adenomyosis, could become pregnant, she has a habitual miscarriage.
Symptoms of the disease depends on the prevalence of the pathological process. Depending on how deeply the cells of the endometrium penetrated, four levels of the disease are distinguished. It:
- The first degree at which a submucosal layer of the uterus is affected.
- The second. In this case, the pathological process extends no more than half the depth of the muscle layer of the uterus.
- Third. Most of the muscular layer of an organ undergoes pathological changes.
- Fourth. The entire muscle layer is affected.
The first degree of adenomyosis is usually asymptomatic. In the second and third degrees, a mild clinical picture may occur. The fourth degree of adenomyosis is the stage at which the manifestations of the pathology are expressed quite clearly.
Danger of adenomyosis during pregnancy
During pregnancy, adenomyosis is especially dangerous, since pathology usually becomes the cause of spontaneous abortion. Other possible complications include the following:
- preterm labor,
- internal bleeding
- placental abruption,
- underweight and fetal growth.
Adenomyosis of various degrees affects pregnancy in different ways. The least dangerous are the first and second stages, the most difficult - the third and fourth.
Adenomyosis is most dangerous in the first months after the onset of pregnancy.
Adenomyosis is detected with the help of such diagnostic measures:
- history taking,
- gynecological examination,
- ultrasound examination of the pelvic organs,
- assessment of the level of individual hormones in the blood (progesterone, estrogen, luteinizing),
When pregnancy is not carried out such diagnostic measures as radiography or hysteroscopy.
According to the results of diagnostic measures, the specialist evaluates the condition of the woman and prescribes a course of treatment.
Disease therapy is aimed at inhibiting the spread of pathological foci, eliminating the threat of termination of pregnancy. The task of therapy is to eliminate the risk of abortion. Drugs are used only on prescription.
In this case, the following drugs are prescribed:
- antispasmodics (antispasmodic),
- sedatives (Calm),
- Means for improving metabolic processes (Glycine).
Most often, women who suffer from adenomyosis, after childbirth hormones change, which contributes to the reduction of the pathological foci. If this does not happen, after delivery, a course of conservative therapy or surgery is prescribed.
After giving birth, a woman can be assigned:
- Hormonal drugs of the progestogen group (Utrozhestan, Farlutar, Vizanna). These drugs contribute to the creation of conditions for implantation of a fertilized egg, preventing endometrial changes.
- Androgenic hormonal drugs (Danazol). The drug reduces the foci of adenomyosis, as the endometrium becomes thinner.
- Oral contraceptives (Janine, Silhouette, Clayra, Yarin). The goal of these drugs is to prevent the risk of pathological tissue growth.
- Herbal remedies of non-hormonal action (Cyclodinone). Medications eliminate hormonal imbalances, have analgesic and anti-inflammatory effects.
- Nonsteroidal anti-inflammatory drugs (Nimesil, Ketoprofen). Such drugs have an analgesic effect, inhibit the inflammatory process, make menstrual flow less abundant.
- Immunomodulatory drugs (Wobenzym). Such medicines not only increase immunity, but also reduce the severity of side effects caused by hormonal drugs.
Also for the treatment of adenomyosis after childbirth can be used means of traditional medicine. This can be done only after consulting a doctor. Frequently used recipes are the following:
- Broth based on yarrow. To prepare it, you need to take a tablespoon of chopped raw materials and pour 200 ml of boiling water. The tool should be infused for an hour, it is taken on the third part of the glass three times a day. This herbal remedy has anti-inflammatory and bactericidal effect, enhances uterine contraction.
- Nettle decoction. To prepare it, you need to take 2 tablespoons of fresh or dry herbs, pour a glass of boiling water, let the liquid brew for 40 minutes. The resulting amount of funds must be divided into several portions and consumed during the day.
- Herbal mixture. It includes buds of birch and poplar, juniper berries, plantain leaves, calamus and tansy. All these components need to be mixed in equal parts, then take a teaspoon of the mixture and pour 200 ml of boiling water. The tool must be infused for an hour. Strain the liquid and take 3-4 ml of 50 ml a day.
- Decoction of dried grass boron uterus. You need to take a tablespoon of the main component and pour 200 ml of boiling water, let it brew for 15 minutes. Take a few tablespoons of the resulting broth for an hour before meals.
- Compresses with blue clay. Clay should be diluted with warm water to obtain a consistency of thick cream. The composition is heated in a water bath, then apply it on the lower abdomen. Apply a layer of food film on top. Stay under the blanket for 2 hours, then wash off the remains of the clay mass with warm water.
It should be borne in mind that in the presence of breastfeeding drugs (including those prepared independently according to popular recipes) must be taken carefully and only under medical supervision. This is due to the fact that the active ingredients can penetrate into breast milk.
An additional method of treatment for adenomyosis in a woman is physiotherapy. With this disease effective:
- magnetic therapy
- laser treatment
- massage, including cupping,
- ultraviolet irradiation.
Treatment of adenomyosis during pregnancy and after childbirth should be carried out under the supervision of a physician.
Prognosis and preventive measures
With the right approach to the treatment of adenomyosis during pregnancy has a favorable prognosis.
To prevent the development of the pathological process before pregnancy, you must follow these rules:
- regularly visit the gynecologist: not only when the characteristic symptoms appear, but also as a prophylaxis,
- do not abuse sunbathing and trips to the solarium,
- avoid stressful situations
- lose weight
- choosing the right contraceptive methods to avoid abortions,
- observe the regime of work and rest,
- take hormonal contraceptives only after consulting a doctor.
Adenomyosis during pregnancy is a rare phenomenon, since the pathology itself in most cases eliminates the likelihood of conception. But in some cases, pregnancy occurs even under these conditions. To avoid spontaneous abortion on this background, you should immediately consult a doctor and begin a course of treatment.
Adenomyosis and pregnancy - features of the course, prognosis and other features + reviews
The article is in the subsection Endometriosis (which is part of the Diseases section)
The reproductive function of a woman depends on many factors. Pregnancy can be a daunting task if the production of a hormone is impaired in the body. Quite often, currently, endocrine pathology manifests itself in the form of internal (uterine) endometriosis - adenomyosis.
What is adenomyosis
Adenomyosis is a pathology, in which there is a proliferation of the inner layer of the uterus beyond. Sections of the mucous membrane, which under the action of sex hormones undergo cyclical changes, begin to form in the muscle layer of the organ. As a result, bleeding foci of the endometrium expand in the uterine wall, and a chronic inflammatory process develops. Foci of such chronic inflammation affect the function of the uterus as an organ intended for carrying a child. The muscular layer can undergo significant changes: thinning, dystrophic restructuring, which leads to disruption of the contractile function of the organ. If pregnancy occurs with the disease, then there is a high probability of threatening to terminate it. Adenomyosis is quite common in women who are diagnosed with infertility. The disease is an indicator of a hormonal failure in a woman’s body. This failure leads to infertility and childbearing problems. Reliably the causes of the atypical location of the mucosal areas are still unknown. However, it is well established that in patients with adenomyosis there are immune and hormonal disorders. Prerequisites for the development of pathology are the following factors:
Causes of the disease
Sections of the mucous membrane, which under the action of sex hormones undergo cyclical changes, begin to form in the muscle layer of the organ.
As a result, bleeding foci of the endometrium expand in the uterine wall, and a chronic inflammatory process develops.
Foci of such chronic inflammation affect the function of the uterus as an organ intended for carrying a child. The muscular layer can undergo significant changes: thinning, dystrophic restructuring, which leads to disruption of the contractile function of the organ. If pregnancy occurs with the disease, then there is a high probability of threatening to terminate it.
Adenomyosis is quite common in women who are diagnosed with infertility. The disease is an indicator of a hormonal failure in a woman’s body. This failure leads to infertility and childbearing problems.
Reliably the causes of the atypical location of the mucosal areas are still unknown. However, it is well established that in patients with adenomyosis there are immune and hormonal disorders.
Prerequisites for the development of pathology are the following factors:
Manifestations of pathology in pregnant women
Before the onset of fertilization, adenomyosis is manifested by pain during menstruation, copious menstruation and a thinning discharge between them, which can be confused with signs of inflammation. However, upon the occurrence of pregnancy, the body experiences a powerful hormonal alteration.
The mucous membrane of the uterus at the time ceases to undergo cyclical changes - there is a regression of the disease. Since there are no bleeding lesions in the uterus during pregnancy, they are, as it were, in a conserved form, they do not reveal any specific manifestations during gestation in adenomyosis.
A single group of signs of pathology may be associated with insufficient utilization of the muscular layer of the uterus and with progesterone deficiency.
The combination of these factors determines the symptoms of threatened abortion:
- lower abdominal pain, worse in the evening or after exercise,
- increased uterus tone, it becomes "hard" to the touch,
- pathological discharge from the genital tract (bloody spotting or clear liquid water).
Compatibility of adenomyosis and pregnancy
A woman suffering from adenomyosis is difficult to get pregnant. According to statistics, up to 80% of patients with this disease cannot become pregnant for a long time. The impossibility of fertilization and subsequent implantation of the embryo, as well as adenomyosis, are associated with hormonal imbalances.
If fertilization has occurred, the patient is under the careful attention of obstetricians because of the high risk of abortion. Increased risk persists until the placenta is formed - the main source of hormones during pregnancy. Therefore, in the early stages (in the first trimester), hormone therapy (for example, Duphaston) is prescribed to patients with adenomyosis.
After 14 weeks, the risk that the pregnancy may stop is reduced. However, the woman is under observation, since the walls of the uterus affected by adenomyosis lose their elasticity. With the growth of the fetus, a gradual stretching of the walls of the uterus may be accompanied by drawing pains in the lower abdomen.
Another feature of pregnancy in adenomyosis is adhesions and nodes in the uterus (with nodular adenomyosis). In case of a pronounced adhesions process, the growing fetus may experience difficulties and assume a forced position.
The diffuse form of pathology is characterized by more or less uniform changes in the uterine wall. With pronounced dystrophic changes in the uterine wall during pregnancy, placental insufficiency often develops, leading to fetal hypoxia and delayed physical and mental development.
The focal form of pathology is dangerous in cases where the placenta is attached in the area of the affected area. This is fraught with the development of one of the most difficult pathologies of pregnancy - placental abruption.
The diagnosis of adenomyosis in a pregnant woman is made on the basis of:
- Survey. The patient usually complains of painful and prolonged menstruation before pregnancy. As well as on the lightening brown-brown discharge a few days before the start of menstruation and within two to four days after cyclical bleeding.
- Inspection. When vaginal examination of the uterus is determined larger than it is necessary for this period of pregnancy. When focal form may be determined tuberosity. Palpation of the uterus is often painful or at least uncomfortable.
- Ultrasound Exam. The discrepancy between the size of the uterus and the duration of pregnancy, increased echogenicity or rarefaction of muscle tissue in the localized lesions is determined.
Therapy of adenomyosis during pregnancy is aimed at solving the following tasks:
- Inhibition of the growth of foci of the mucous membrane of the uterus. Androgens or progestogens are used for this. Drugs and dosages selects the attending physician.
- Eliminate the threat of termination of pregnancy. For this course is assigned:
- antispasmodics (No-shpy, Papaverina, etc.),
- agents that improve metabolic processes (for example, Glycine).
In addition to these measures, other methods of treatment of adenomyosis during pregnancy do not apply, because:
- Taking any medications or procedures during this period increases the risk of adverse effects on the fetus. First of all, the main rule of medicine works - “do no harm”. Treatment of the disease can be postponed for the postpartum period.
- The threat of termination of pregnancy comes to the fore, it develops in a significant proportion of patients with this diagnosis. Therefore, drug therapy is aimed precisely at the elimination of this problem.
In some cases, after birth, the hormonal balance may change and the foci of adenomyosis will gradually begin to decrease in size. If this does not occur, the patient is given conservative or surgical treatment after the birth of the child.
Conservative treatment of adenomyosis outside of pregnancy includes:
- hormones that mimic the state of menopause. The course of treatment ranges from four months to a year.
- nonsteroidal anti-inflammatory drugs for severe pain syndrome,
- decoctions and herbal extracts, as well as other methods of traditional medicine. The attending physician may prescribe herbs in the form of douching, and for ingestion.
Infusions will help reduce the bleeding of tissues and relieve inflammation in the myometrium:
- Shepherd's purse. A teaspoon of dry grass is poured with a glass of boiling water, infused for an hour and taken in a tablespoon four times a day half an hour before meals.
- Nettle. Two tablespoons of dry or fresh herbs is poured with one glass of boiling water and infused for 40 minutes. The entire amount of funds must be divided into several techniques and consumed in one day.
- Plantain leaves. A tablespoon of dry or fresh herbs is poured with a glass of boiling water and infused for two hours. The resulting infusion is divided into four parts, first you need to eat on an empty stomach, the rest can be after a meal, evenly throughout the day.
In addition to herbal therapy, inflammation in the uterus muscle can be reduced by:
- Hirudotherapy. The leeches are placed on the lower abdomen under the supervision of a physician. Special enzymes that contain these animals have powerful anti-inflammatory and regenerative properties.
- Blue clay wraps. The application of clay to the groin area improves blood circulation in the pelvis and, in combination with other treatment methods, accelerates the regeneration of the myometrium.
If conservative therapy has not led to the desired effect, complications have arisen, then resort to surgical treatment of adenomyosis.
Indications for surgery are:
- Severe uterine bleeding.
- The combination of adenomyosis and fibroids of large sizes.
- The combination of adenomyosis with atypical changes in the endometrium or epithelium of the cervical canal.
Completely safe from this disease is hardly possible. Women who have hormonal and metabolic disorders need to especially carefully monitor the state of the internal genital organs and follow simple rules:
- Visit the gynecologist at least twice a year and undergo an ultrasound of the pelvic organs.
- If there were problems with menstruation - they became painful, abundant, there were spotting a few days before menstruation - it is better not to postpone the visit to the gynecologist.
- To establish the correct mode of the day and a balanced diet, to get rid of excess weight.
- Reconsider the attitude to nervous overloads.
- Do not allow yourself excessive emotional fatigue, periodically receive courses of relaxing massage and physiotherapy procedures aimed at strengthening the nervous system.
Reviews of women who have had the disease
Adenomyosis may not manifest itself. Foci of atypical location of the uterine mucosa can easily exist before menopause, and then undergo a natural regression. But if the symptoms of the disease manifest themselves at the reproductive age, and according to the plan - pregnancy and childbirth, the pathology must be carefully treated to avoid subsequent problems.
Adenomyosis and pregnancy: is it possible to get pregnant with the disease? / Mama66.ru
Adenomyosis or internal endometriosis is a pathological process affecting the body of the uterus, with the spread of the inner layer of the mucosa in the thickness of the walls of the organ.
Against this background, a specific picture of the disease with concomitant serious complications is being formed.
For example, adenomyosis and pregnancy often become mutually exclusive because the disease usually leads to infertility.
This gynecological pathology ranks third in the ranking of all diseases of the female genital tract. Since in most cases it is found in women of childbearing age, it deserves close attention.
How is adenomyosis manifested?
The insidiousness of this disease is that it can be hidden, for a long time without making itself known. In some cases, it is detected by chance, during a routine examination by a gynecologist.
Suspected the presence of adenomyosis can be on the following clinical signs:
Unfortunately, many women consider painful and copious periods to be the norm, taking it as a feature of the organism or attributing to it their own conjectures. They are not in a hurry to consult a doctor, and the disease is slowly progressing at this time.
There are 4 stages of the disease:
- The endometrium does not sprout out, but inside the uterine walls, penetrating 1/3 of their thickness.
- Endometrium grows to ½ of the thickness of the uterine wall.
- Endometrium extends more than half the wall of the organ.
- The endometrium grows through the entire thickness of the uterine wall, going out into the abdominal cavity, with the subsequent involvement of the internal organs in the process.
Who is most affected by it?
Most often, the disease affects women of childbearing age, namely from 17 to 35 years. The risk group consists of patients who have undergone induced abortion and miscarriage, surgery on the uterus.
Less commonly, the disease is diagnosed in patients whose work activity is associated with severe physical conditions and stress.
But adenomyosis can be diagnosed in those women who have not experienced the causes listed above.
Pregnancy and uterine adenomyosis as two incompatible concepts become the main problem of a woman ready for motherhood.
In the patient's body, the level of estrogen is increased, but unstable, which provokes the development of internal endometriosis, which prevents the onset of pregnancy.
In women older than 35 years, the natural level of estrogen begins to gradually decrease, so the diagnosis of adenomyosis is made much less frequently.
Can I get pregnant with adenomyosis?
Usually, internal endometriosis causes infertility.
Uterine adenomyosis and pregnancy as mutually exclusive concepts are associated with the following reasons:
- the egg cannot penetrate into the body of the uterus against the background of violation of the contractile activity of the fallopian tubes,
- ovulation does not occur due to hormonal imbalance,
- autoimmune reactions in a woman’s body inhibit the activity of male germ cells and interfere with the implantation of a fertilized egg and the development of pregnancy,
- pain during intercourse prevents the maintenance of regular intimate life,
- early termination of pregnancy as a result of increased contractility of the uterine muscle layer and inflammation in it.
Pregnancy with adenomyosis is possible if comprehensive treatment aimed at restoring reproductive function is performed. The effectiveness of therapeutic effects depends on the duration of the disease. If adenomyosis has bothered a woman for no more than 3 years, the result of the treatment is likely to be positive.
What to do so that the disease does not hinder motherhood?
To avoid any doubts whether it is possible to become pregnant with uterine adenomyosis, and the disease does not poison life, it is important to regularly undergo gynecological examinations and consult a specialist if you have any signs of ill-being. Timely diagnosed pathology is easily treatable and does not affect the ability to become pregnant.
At 1 and 2 stages of adenomyosis, the prognosis for recovery is favorable. It should be noted that the disease is prone to relapses with hormonal imbalance, therefore it is difficult to speak of a 100% cure. So that the disease does not interfere with maternity, after therapy it is important to monitor your health and not to resort to self-treatment.
3 and 4 stages of adenomyosis in 90% of cases mean persistent infertility. In this case, the treatment is performed surgically. During the operation, the doctor excises the affected tissues of the uterus, preserving the organ, if possible. In stage 4 of the disease, the uterus and ovaries are usually removed.
Conservative treatment in the initial stages of the disease includes taking oral contraceptives, multivitamin complexes and immunomodulators. Hormonal treatment is most effective, since half of women after a course of oral contraception have a healthy pregnancy.
Features of the course of pregnancy in adenomyosis
The presence of this disease during childbirth is always a risk factor. It is easiest to proceed with pregnancy with adenomyosis of 1 degree.
Symptoms of endometriosis with the onset of conception subside, but after giving birth, with the first menstruation, they will return again. If the pregnancy, despite the diagnosis, has come, it must be preserved. Otherwise, abortion may cause recurrence of the disease, and in the future it will take a more severe course. Often a woman is threatened with miscarriage.
Nevertheless, pregnancy can favorably affect the course of the disease, since, in fact, it causes physiological menopause in the body - the absence of menstruation. In turn, this inhibits the pathological process of the spread of foci of internal endometriosis. That is, the disease temporarily does not progress.
Adenomyosis is a serious disease that can be treated if it is started on time. But it needs to be treated before the intended conception, so as not to complicate the course of the pregnancy and not cause postpartum complications. At an early stage, curing adenomyosis is not difficult, and, most importantly, it cannot affect the reproductive function of a woman.
Uterus adenomyosis and pregnancy
Adenomyosis and pregnancy. Adenomyosis is called uterine endometriosis. This is an inflammatory process. But in order to understand what it is, let's first learn what endometriosis is. Can I get pregnant with uterine adenomyosis? Adenomyosis is the second leading cause of female infertility after inflammatory diseases of the female genital tract.
Many women anxiously ask whether adenomyosis and pregnancy are compatible? The answer is simple: it is possible, but difficult. Unfortunately, the prognosis for pregnancy with this disease is disappointing. Adenomyosis causes infertility in 40 percent of cases.
Adenomyosis of the uterus (endometriosis of the uterus) - a disease in which in the tissues of the uterus, ovaries, and other tissues there are lesions that resemble the structure of the uterine mucosa, are small nodules that contain dark thick fluid. In such foci, changes similar to the rejection of the uterine mucosa occur.
The developed bleeding from these areas leads to pain during menstruation. Modern doctors adenomyosis is usually called a disease such as endometriosis of the uterus. And endometriosis is a serious inflammatory process.
Endometrial foci can be localized in various organs and tissues: on the cervix, in the thickness of the uterus, on the wall of the abdominal cavity, outside the reproductive system organs.
Uterine adenomyosis symptoms
The most common symptom is pain appearing or intensifying in the premenstrual days, during menstruation. With the defeat of the uterus can be abundant menstruation, bleeding from the genital tract before and after menstruation.
The pain can be given to the region of the sacrum, rectum, vagina. Adenomyosis of the uterus can occur without symptoms, in which case this pathology is detected when patients come to the clinic with the question that they can not conceive a child.
Is there a chance to make and give birth to a healthy child? Uterine adenomyosis is often accompanied by infertility. Infertility is placed if the pregnancy has not occurred within one or more years with regular sex life. In uterine adenomyosis, implantation of the ovum into the uterine mucosa is impossible, and the egg cell is lost.
With adenomyosis of the uterus, an adhesive process is noted, which leads to infertility. There is a violation of the patency of the fallopian tubes, which leads to the absence of pregnancy. With adenomyosis of the uterus, there can be a lack of egg maturation in the ovary, a change in the properties of the uterine mucosa itself.
When a diagnosis of adenomyosis of the uterus is established, therapy with gestagens is prescribed, while taking it may cause pregnancy. This group of drugs should not be canceled, they must be taken further to provide the necessary hormonal support.
It is known that the disease is characterized by the presence of hormonal disorders, so the first trimester of pregnancy is the most responsible. As a rule, pregnant hormones should take up to 14 weeks. But this must be controlled by taking into account the results of the blood test for progesterone.
Based on the results of the examination, the question of the abolition of gestagens or the continuation of therapy is decided. Numerous studies have been carried out, according to which no information was obtained about the negative effect on the fetus of hormones, in particular, dydrogesterone.
This drug is widely used in obstetric practice and contributes to the creation of optimal conditions for the progression of pregnancy.
The most frequent complication of pregnancy in adenomyosis is the threat of its interruption. This situation requires preventive courses to prevent the development of a threat clinic. Prescribe drugs from the group of antispasmodics, sedatives, sedatives that improve metabolic processes.
Causes of uterine adenomyosis
Uterine adenomyosis is due to genetic predisposition. There is a theory of the hormonal development of the disease, according to which there is a violation of the content and ratio of hormones in a woman’s body.
Another theory of the occurrence of uterine adenomyosis is the implantational one, according to which the endometrium particles that have been detached are deposited on the ovaries, tubes, and peritoneum, creating the “soil” for the development of the ailment.
The most important are negative changes in the neuroendocrine system due to stress, malnutrition, and various non-gynecological diseases.
Treatment of uterine adenomyosis
Treatment of uterine adenomyosis is performed by surgical correction, physiotherapeutic methods, hormone therapy. In recent decades, hormonal drugs have been prevalent in drug therapy for uterine adenomyosis. They temporarily stop menstruation, suppress ovarian function.
They create artificial menopause, which leads to a decrease in the severity of symptoms of the disease, a decrease in foci of uterine adenomyosis. Hormonal drugs of the last generation have a minimum of side effects compared with drugs of previous generations. Treatment with such hormonal drugs is used as the first stage of treatment before surgery.
Oral hormonal contraceptives are also used in the treatment and prevention of the progression of non-severe forms of uterine adenomyosis.
The greatest effect can be obtained with a combination of a hormonal and surgical method of treatment - laparoscopy, during the operation endometrial foci are removed. Hormones can be used as a preoperative preparation, for 3-6 months after surgery as a preventive measure against the onset of symptoms of uterine adenomyosis.
Pregnancy planning for uterine adenomyosis
Laparoscopy is resorted to, if there are endometrioid ovarian cysts, there is a need to establish the patency of the fallopian tubes. After surgery for 3-6 months, hormone therapy is usually prescribed. Hormonal drugs immerse the reproductive system in sleep.
After a few months, the therapy is canceled, the patient is allowed to become pregnant. If the pregnancy does not occur within one year, then it drastically reduces the chances for the restoration of the reproductive function of the woman. In this case, the recommended program IVF.
During pregnancy and lactation in the absence of menstruation, a reverse development of uterine adenomyosis can occur. Interruption of pregnancy with curettage of the uterus leads to aggravation and aggravation of uterine adenomyosis.
Timely examination, treatment of uterine adenomyosis helps pregnancy.
The presence of adenomyosis does not mean that pregnancy will occur in all pregnant women with complications.
A large percentage of patients do not even know that they have such a disease, while conception occurs without any problems. In this situation, it is not necessary to immediately use hormone therapy.
It is necessary to conduct a comprehensive examination of the woman, her hormonal profile, so that you can assess the need for medical treatment.
If a woman suffers from adenomyosis and plans a pregnancy, then she should be prepared for such an important period in her life.
Conducting a full examination and appropriate treatment depending on the results obtained is a guarantee that the pregnancy will come, and will proceed without complications. Particular attention is paid to the diagnosis of infections that are STIs.
With adenomyosis, a decrease in the protective, immune forces of the body occurs. Pregnancy is a state of natural immunodeficiency, so this may lead to the fact that the infectious process during pregnancy will be accompanied by various complications.
It is necessary to prescribe a course of specific therapy before pregnancy, since the list of drugs approved for pregnant women is very limited.
It can be argued that for a woman the diagnosis of adenomyosis should not mean that she will not be able to give birth to a healthy baby. The most important thing is to follow the recommendations of a specialist in the treatment of this disease and to approach the planned pregnancy responsibly.
Adenomyosis and pregnancy - is pregnancy possible in adenomyosis
Uterine adenomyosis is a disease in which the inner layer of the uterus (endometrium) grows. Поэтому другое название этой болезни — эндометриоз. По сути, природой так устроено, чтобы каждый менструальный цикл эндометрий нарастал в матке.
Он необходим для того, чтобы в нем могла закрепиться оплодотворенная яйцеклетка, и наступила беременность. If conception does not occur, the endometrium begins to flake off, causing bleeding, which we call monthly.
In this article we will talk about when adenomyosis can be dangerous to the health of a woman, and also tell you about the features of the course of pregnancy after uterine adenomyosis.
Adenomyosis and pregnancy: risks and dangers
A woman with endometriosis, becoming pregnant, risks health. After all, her risk of miscarriage or premature birth increases several times, compared with other women who do not have such a serious pathology. Virtually the entire pregnancy in a patient with adenomyosis will take place under strict adherence of doctors.
Childbirth can pass safely, the postpartum period will be much more difficult when uterine bleeding opens, which can sometimes be stopped only by removing the uterus.
Nevertheless, it is necessary to take into account that each case is individual - for one woman everything goes without problems, and for the other all troubles will make themselves felt immediately.
If you have adenomyosis, you just need to be very careful about your condition and follow all the doctor's instructions.
Video: “Adenomyosis - Should I Treat?”
In this video, a young obstetrician-gynecologist Dmitry Lubnin talks about adenomyosis disease, which can occur in all women at any age.
Separately, he focuses on ways to treat this disease and explains why pregnancy may be the only way to treat diffuse adenomyosis. Note that many modern doctors do not share this view.
However, for women who want to experience the joy of long-awaited motherhood, it will be useful to hear the opinion of a professional so as not to lose heart and continue trying to give birth to a healthy and strong baby without risks to their lives.
Adenomyosis and pregnancy: can you get pregnant with a diffuse form, can you do IVF, how to cure
Adenomyosis of the uterus, which is also called internal endometriosis, is a serious disease, culminating in infertility. Pathology develops predominantly in women of young reproductive age.
Often found suddenly, when the patient turns to the doctor about the inability to conceive a child. The compatibility of pregnancy and endometriosis is questioned. However, these concepts cannot be completely mutually exclusive.
It is necessary to consider each case separately to talk about the chances of a successful conception.
Symptoms and diagnosis
In accordance with the form and stage of the disease, the symptoms of adenomyosis can have a vivid clinical picture or even not show themselves. Patients usually complain about the following symptoms:
- breakthrough bleeding, daub between periods, and menstrual periods with adenomyosis are long,
- prolonged premenstrual syndrome
- pulling sensations in the pelvis not only during menstruation, pain can persist throughout the cycle,
- discomfort during sexual contact.
The rest of the clinical picture is determined during diagnosis. For diagnosis, obstetric history, gynecological examination, ultrasound, as well as additional instrumental manipulations are performed at the discretion of the doctor.
- Ultrasound - the study of the cavity of the reproductive organ through ultrasound. The painless, fast manipulation which is not demanding additional preparation. May show an increase in the uterus, the presence in the layers of hyperechoic inclusions with a smooth contour (a sign of focal shape).
- Hysteroscopy is a low-impact study that allows to assess the state of the uterus from the inside. It can show not only the presence of internal endometriosis (adenomyosis), but also determine its shape.
- Laparoscopy - diagnostic manipulation, which can turn into medical, is performed under general anesthesia. The procedure allows to visually assess the stage of adenomyosis, endometriotic localization and shape.
- Biopsy - a study that allows to thoroughly study the stage and form of the disease. If diffuse adenomyosis of the 4th stage is detected, then the uterus is removed.
In some cases, patients are prescribed hysterosalpingography as an additional examination. The procedure informatively shows the state of the fallopian tubes (passable or not), which can be involved in the formation of genital endometriosis.
If during menstruation the pain appears every time and persists for a long time, and the bleeding is large, you should at least make an ultrasound that can detect the beginnings of adenomyosis.
Can I get pregnant with uterine adenomyosis?
The concepts of adenomyosis and infertility are often used together. Indeed, this disease impairs the functioning of the reproductive organs. Chance of conception is small, but they are. Repeated clinical cases prove that you can get pregnant with adenomyosis. The less damage to the muscular layer of the uterus, the more likely the onset of self-conception.
In women with focal adenomyosis of 1 degree, pregnancy can occur in the natural cycle, if there are no other health problems. If you first consult a doctor and carry out treatment, the probability of a positive result can be increased. It happens that the patient finds out about her diagnosis at the moment when she comes to get registered for pregnancy.
The spread of endometrium over large areas or diffuse adenomyosis leaves little hope for independent conception and this is why:
- the penetration of the mucous membrane into the muscle layer of the uterus forms a violation of the contractile function, and also causes malfunction of the neighboring organs,
- the spread of the disease to the fallopian tubes causes their reverse peristalsis and narrowing of the lumen,
- pathological changes in the hormonal background cause the lack of ovulation and cause abnormal growth of the endometrium (hypoplasia or hyperplasia),
- the altered immune system perceives sperm and the ovum by alien objects, rejecting them,
- adenomyosis is often accompanied by diseases such as PCOS (polycystic ovary syndrome), myoma, inflammation,
- painful sensations, which are a symptom of pathology, do not allow to have a regular sex life.
If there are problems with conception, and independent pregnancy does not occur more than six months with regular sex life, it is necessary to be examined. Violations of the menstrual cycle, pain in the pelvis, prolonged bleeding - a reason for immediate treatment to the gynecologist.
Pregnancy with adenomyosis
In patients with little damage to the muscle layer of the uterus without hormonal abnormalities, pregnancy with adenomyosis can occur. But even if conception has happened, it is too early to exhale and relax.
Internal endometriosis - uterine adenomyosis - an insidious disease that can cause various pathologies in pregnant women and even provoke a miscarriage.
Therefore, patients with such a diagnosis should be under the supervision of gynecologists during the entire gestational period.
In pregnancy (at any time) adenomyosis causes an increased contractility of the reproductive organ. Due to the lesion of the muscular layer, a thickening of certain areas occurs, which threatens with rejection of the ovum, and in 2-3 trimester may cause premature detachment of the placenta.
Due to hormonal disorders in endometriosis of the uterus, the ovaries supply an insufficient amount of progesterone, which is the starting point for the development of hypertonus.
If you do not apply maintenance therapy, the pregnancy may be interrupted. In women with adenomyosis during gestation, the risk of fetal hypoxia remains.
If the embryo is attached in the place where the focus of the disease is located, the blood circulation is disturbed.
The risk of complications is present throughout the gestation period, so the expectant mother, who has a diagnosis of internal endometriosis, should consult a doctor at the first sign of poor health.
There is an opinion that pregnancy is a kind of treatment for uterine adenomyosis. With the onset of conception, the patient stops menstruation and preserves the ovulatory function of the ovaries. Menstruation stops coming monthly and an artificial sensation of menopause is created for the genital organ.
Endometrial foci not only cease to function, but also decrease in size. There are cases when pregnancy and subsequent long-term breastfeeding with the absence of menstruation led to recovery.
Eco with adenomyosis
For patients with adenomyosis with impassable tubes, the use of assisted reproductive technology is suggested.
Laparoscopy is pre-prescribed, during which non-functioning parts are removed to avoid ectopic pregnancy.
Before entering into the protocol, a woman is prescribed hormone therapy, which involves creating the illusion of an artificial menopause for the body. Reducing the volume of lesions during treatment increases the chances of a successful outcome.
Immediately after leaving the menopause, ovulation simulation and further hormonal support is performed. With a positive result, the expectant mother is under the supervision of physicians for the entire period of time and is subjected to constant examination. Support for drugs based on progesterone is canceled no earlier than in the middle of pregnancy.
Adenomyosis and IVF are closely related. However, the severity of the pathology is always taken into account. Statistics show that patients with stage 1 focal endometriosis of the uterus are more amenable to the method. With extensive damage to the myometrium and its diffuse changes, IVF is not performed, since the probability of a good result tends to zero.
Thanks to the possibilities of modern medicine, uterine adenomyosis has ceased to be a sentence for women. To get pregnant with this disease, you need:
- consult a gynecologist,
- be examined
- undergo treatment
- if necessary, resort to assisted reproductive technologies.