Adenomyosis is a uterine condition that can cause painful periods, heavy bleeding, pelvic pain, and fertility concerns. It occurs when tissue similar to the uterine lining grows into the muscle of the uterus.
If you are trying to conceive, you may wonder whether adenomyosis affects your chances of pregnancy. Adenomyosis does not mean pregnancy is impossible, and many women conceive naturally or with fertility treatment.
Understanding how adenomyosis affects fertility and pregnancy can help you explore the right treatment and conception options with your doctor.
Adenomyosis occurs when the tissue normally found lining the inside of the uterus, known as the endometrium, grows into the muscular layer of the uterine wall, called the myometrium.
This can cause the uterus to become enlarged or more bulky and may lead to inflammation and changes in the uterine muscle.
Adenomyosis is different from endometriosis, although the two conditions can occur together.
In endometriosis, tissue similar to the uterine lining grows outside the uterus, while adenomyosis involves the muscular wall of the uterus.
The exact cause of adenomyosis is not fully known. Hormonal changes and changes where the uterine lining meets the uterine muscle may play a role.
It is more commonly diagnosed in women over 30 and may be associated with previous pregnancy or endometriosis.
Some factors linked with adenomyosis include:
Having these factors does not mean you will develop adenomyosis. The condition can affect women of different ages and reproductive backgrounds.
Adenomyosis can cause symptoms that affect your comfort, menstrual health, and sometimes your ability to conceive. Some women have mild symptoms, while others may have more noticeable problems.
Common symptoms include:
Not everyone with adenomyosis has fertility problems.
However, if you have persistent symptoms while trying to conceive, speaking with a fertility specialist can help identify the cause and discuss suitable treatment options.
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Adenomyosis may make it harder to become pregnant by changing the uterus and affecting embryo implantation.
Inflammation and changes in the uterine muscle may also affect how the uterus functions.
It may affect fertility by:
However, adenomyosis does not mean you cannot get pregnant. Many women conceive naturally or with appropriate fertility treatment.
Yes, it is possible to get pregnant naturally with adenomyosis.
Having this condition does not automatically mean you will need fertility treatment or that you cannot have a healthy pregnancy.
Some women with adenomyosis conceive without medical help, especially when there are no other fertility problems. However, the condition may affect fertility in some cases, so it is important to consider your overall reproductive health.
If you have been trying to conceive without success, a fertility test can help identify possible causes.
Your doctor may check ovulation, ovarian reserve, sperm health, fallopian tubes, and the uterus before recommending the next step.
Adenomyosis does not mean you cannot have a healthy pregnancy. However, it may increase the chance of some complications.
These may include:
The risk is different for every woman. Regular pregnancy care can help your doctor monitor your health and your baby’s development.
Adenomyosis is usually diagnosed by looking at your symptoms and examining the uterus with imaging tests. The main tests include:
Your doctor may also check for other conditions, such as fibroids or endometriosis, which can cause similar symptoms.
If you are trying to get pregnant, treatment for adenomyosis should help manage symptoms without unnecessarily affecting your fertility.
Your doctor may consider options based on the severity of your condition and your pregnancy plans.
Common options include:
The best treatment depends on your individual situation, so a fertility specialised clinic can help you choose an approach that supports both symptom control and your pregnancy goals.
If natural conception does not occur, fertility treatment may be considered based on the complete fertility assessment.
Depending on your circumstances, options may include:
The best option depends on factors such as age, ovarian reserve, sperm quality, fallopian tube health, duration of infertility, and the severity of adenomyosis.
For some women undergoing IVF, a fertility specialist may consider treating or suppressing adenomyosis before embryo transfer.
One approach involves medicines that temporarily suppress ovarian hormone activity, such as GnRH agonist treatment.
However, there is no single pre-IVF treatment that is appropriate for everyone.
Current evidence remains limited, and ASRM notes that more high-quality research is needed to determine which patients are most likely to benefit from specific treatments before embryo transfer.
Your fertility specialist may therefore consider the severity of adenomyosis, previous IVF outcomes, age, ovarian reserve, and other reproductive factors before creating a treatment plan.
Yes, some treatments can help manage adenomyosis while preserving your ability to become pregnant.
The right option depends on your symptoms, the severity of adenomyosis, and whether you are trying to conceive now.
Common fertility-friendly approaches may include:
Hormonal treatments can control adenomyosis symptoms but usually prevent pregnancy while you are using them.
Your doctor can help choose a treatment that balances symptom control with your plans for pregnancy.
If you have adenomyosis and want to become pregnant, consider discussing the following with a fertility specialist:
Adenomyosis can make pregnancy planning more challenging, but it does not mean you cannot become pregnant. Many women conceive naturally, while others may benefit from fertility treatment or medical care.
The right approach depends on your symptoms, age, fertility goals, and the severity of adenomyosis. A proper evaluation can help identify the best treatment and conception options.
With personalized care and the right support, adenomyosis does not have to prevent you from pursuing your goal of becoming a parent.
