2.1. Study participants
adenomyosis, ovulation disorder, infertility, dysmenorrhea
EXCESSIVE MENSTRUAL FLOW, SECONDARY INFERTILITY, ADENOMYOSIS, DYSMENORRHEA, BLOCKED FALLOPIAN TUBES, IRON DEFICIENCY ANEMIA
A prospective clinical trial was conducted between December 2007 and September 2016 at Dongguk University Ilsan Hospital, South Korea. Fifty study participants were selected based on the following criteria: patients diagnosed with diffuse adenomyosis via pelvic ultrasonography and magnetic resonance imaging (MRI); patients who had excessive menstrual flow (≥80 mL by pictogram) and severe dysmenorrhea (numeric rating scale [NRS] ≥ 6) that disrupted daily life; patients who had been diagnosed with primary or secondary infertility for more than a year, and their infertility was determined to be due to adenomyosis based on clinical assessment by an infertility expert; patients who did not have any other medical conditions, excluding iron deficiency anemia; patients who failed to conceive after treatment with drugs, such as gonadotropin-releasing hormone agonist (GnRHa); and infertile patients who had adenomyosis and other infertility factors, such as ovulation disorder and blocked fallopian tubes, yet their implantation failure was determined to be due to adenomyosis after more than 2 failed attempts to conceive through in vitro fertilization and embryo transfer (IVF-ET) and/or ovulation induction.All patients underwent gynecological examinations and workup, including pelvic ultrasonography and MRI (Fig. Representative images of MRI and trans-vaginal ultrasonography. (a) MRI scans of 4 different patients show adenomyosis. (b) Trans-vaginal ultrasonography was used to measure the adenomyotic lesion. (c) Trans-vaginal ultrasonography 3 to 6 mo follow-up after surgery. MRI = magnetic resonance imaging.