Ultrasound findings in infertile women with endometriosis: evidence of concomitant uterine disorders

Abstract

Endometriosis is a gynecological disease characterized by pain and infertility. The diagnosis is very often made during the infertility work-up, together with other reproductive diseases and uterine disorders. A retrospective cohort study was conducted on infertile women with clinical or ultrasound suspect of endometriosis, undergoing an ultrasound (US) evaluation by a team of expert sonographers (n = 419), with the aim to evaluate the prevalence of concomitant uterine disorders. The US coexistence of endometriosis with uterine fibroids and/or adenomyosis was investigated according to three age intervals (<35years; 35 ≥ years <45; ≥45 years) and to endometriosis phenotypes: ovarian endometriosis (OMA), deep infiltrating endometriosis (DIE), or both. The US diagnosis of fibroids was made in 3.1% of cases, adenomyosis was found in 21.2%, and the co-existence of both uterine disorders with endometriosis was reported in 14.6% of patients. When analyzed according to age, patients aged >35 years were more likely to be affected by uterine fibroids (p = .003), adenomyosis (p = .030) and both adenomyosis and fibroids (p < .0001). No statistically significant association was found between endometriosis phenotypes and myometrial pathologies. Uterine disorders coexistence should be considered in the assessment of women with endometriosis, in order to better define a treatment strategy for infertility, especially in women older than 35 years.

摘要

子宫内膜异位症是一种以疼痛和不孕为特征的妇科疾病。通常是在不孕检查中与其他生殖疾病和子宫疾病一起诊断。我们对于临床或超声可疑子宫内膜异位症的不孕妇女进行了一项回顾性队列研究, 由专业超声检查人员（n=419）进行超声（US）评估, 目的是评估合并子宫疾病的患病率。根据三个年龄区间（<35岁;35岁<45; 45岁）和子宫内膜异位症表型：卵巢子宫内膜异位症（OMA）, 深层浸润性子宫内膜异位症（DIE）, 研究了子宫内膜异位症与子宫肌瘤和/或子宫腺肌症共存的情况。超声提示有3.1％的病例诊断为子宫肌瘤, 在21.2％的病例中发现了子宫腺肌病, 在14.6％的患者中, 两种子宫疾病与子宫内膜异位症并存。根据年龄区间分析, > 35岁的患者更易患子宫肌瘤（p=.003）, 子宫腺肌病（p=.030）以及子宫腺肌病和肌瘤并存（p <.0001）。子宫内膜异位症表型与子宫肌层病理之间无统计学上的显着相关性。子宫内膜异位症的评估中应考虑并存子宫疾病, 以便更好地确认不孕症的治疗策略, 尤其是对于35岁以上的女性。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Adenomyosis
• endometriosis
• infertility
• transvaginal ultrasound
• uterine fibroids

Disclosure statement

No potential conflict of interest was reported by the author(s).