Can Patients with Mild Adenomyosis Get Pregnant?

Nowadays, patients with adenomyosis tend to be younger and younger. Many patients with adenomyosis still have fertility requirements. These sisters are most worried about whether adenomyosis will affect fertility and pregnancy.

Can women with mild adenomyosis get pregnant?

Whether adenomyosis can lead to pregnancy depends on the degree of adenomyosis. If it is a mild adenomyosis, we generally recommend that patients actively conceive, as pregnancy is a very good treatment for adenomyosis. Full-term pregnancy, including prolonged breastfeeding after pregnancy, can have a good inhibitory effect on adenomyosis.

However, it should be noted that if the patient does not receive treatment when the degree of adenomyosis worsens, the patient may experience symptoms such as uterine enlargement and increased menstrual blood volume, which can also affect ovarian function and normal ovulation, which may affect pregnancy.

If the uterus is too large to conceive, we can first undergo some treatment to make the uterus contract and wait until the uterus contracts before getting pregnant. At this time, it is still possible to conceive normally.

How to treat adenomyosis?

1. Injection of uterine adenomyosis for menopausal treatment can bring hormone levels in the body to the menopausal state, which can slowly atrophy the ectopic endometrium and thus play a therapeutic role. This method is also known as drug-induced ovarian or physical pituitary resection, so this type of patient can be relieved after menopause.

2. Some scholars of uterine adenomyosis believe that oral medication hormones can cause the uterine membrane to undergo degeneration and atrophy, thereby achieving control of the development of uterine gland diseases. Some patients choose to continuously release effective hormones in the local area of the uterus, which can control endometriotic lesions between uterine muscle walls.

3. According to traditional Chinese medicine's understanding of uterine glands, uterine adenomyosis is related to congestion, and pathogenic factors such as cold coagulation and phlegm dampness can lead to congestion formation. Regarding treatment, promoting blood circulation as the principle and addressing the causes of blood formation and patient weakness should be emphasized. Traditional Chinese medicine Fuyan Pill promotes blood circulation and resolves blood stasis, which can effectively alleviate the symptoms of patients. At the same time, it can enhance physical fitness and improve patients' chances of conception.

Because adenomyosis of the uterus is more common in middle-aged women, with the majority having already given birth, and the dysmenorrhea and increased menstrual flow caused by the disease are often severe, surgical removal of the uterus is a common treatment method.

Surgical treatment:

1. Complete hysterectomy: For patients without fertility requirements and with clinical symptoms that seriously affect their quality of life, it is generally recommended to undergo a complete hysterectomy, and ovarian preservation depends on the patient's age. Laparoscopic surgery or laparotomy should be chosen according to the specific situation.

2. Excision of adenomyosis lesions to preserve fertility: that is, through laparoscopy or laparotomy, without cutting the endometrium, try to remove the lesion as much as possible and suture to repair the uterus. For patients with adenomyosis with clear boundaries, especially adenomyomas, adenomyomectomy can significantly improve postoperative dysmenorrhea, excessive menstruation, and other conditions. But, it cannot achieve the goal of radical treatment of adenomyosis.

3. Endometriectomy under hysteroscopy: For patients who are older or have no fertility requirements, the majority of the endometrium and superficial adenomyosis lesions can be removed to achieve the treatment goal. However, for patients with deeper lesions or no fertility requirements, the depth of lesion infiltration should be understood through vaginal ultrasound before use.

4. Uterine neurectomy: Laparoscopic hysterectomy involves the removal of nerves or presacral nerves within the uterosacral ligament using methods such as an electric knife or laser under laparoscopy, resulting in blockage of the pain nerves in the uterus. Although surgery is more difficult for women with strong fertility, it has a better effect in controlling long-term pain than traditional surgery.