Page 48 - ESHRE2019
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   Clinical implications
• Pelvic pain, abnormal uterine bleeding • Infertility?
– Impair gamete transport
– Increased level of nitric oxide in the endometrium that affects sperm function
and implantation.
– Altered uterine peristaltic activity
– Altered endometrial‐myometrial vascular growth and higher expression of aromatase cytochrome P450 in the endometrium.
• Effects of adenomyosis on fertility and on IVF outcome remain unclear
 5
  Effects of adenomyosis on IVF treatment outcome: A meta‐analysis
(Younes & Tulandi, Fertil Steril 2017)
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