Hysteroscopic Treatment of Adenomyosis and its Impact on Pregnancy Outcomes: A Mini Review

Chrisostomos Sofoudis^1*, Spiros Delis^2
11^st Department of Obstetrics and Gynecology, Elena Venizelou, Maternity Hospital, Elena Venizelou, Athens, Greece.
²HPB Unit, Konstandopouleio Hospital Athens, Greece.

Correspondence to: Chrisostomos Sofoudis, 1^st Department of Obstetrics and Gynecology, Elena Venizelou, Maternity Hospital, Elena Venizelou, Athens, Greece.
Received date: September 08, 2025; Accepted date: September 16, 2025; Published date: September 23, 2025
Citation: Sofoudis C, Delis S. Hysteroscopic Treatment of Adenomyosis and its Impact on Pregnancy Outcomes: A Mini Review. J Obst Gynecol Surg. 2025;6(1):6-9. doi:10.52916/jogs254041
Copyright: ©2025 Sofoudis C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

The presence of endometrial glands and stroma within the myometrial wall histologically characterizes adenomyosis, a complicated and multivariate uterine condition. Adenomyosis, which was formerly believed to largely affect multiparous women in their 40s and 50s, is now more widely recognized in younger patients, especially those who have infertility or recurrent pregnancy loss. While there are many different clinical signs, the most common ones are menorrhagia, dysmenorrhea, persistent pelvic pain and most importantly impaired fertility. The development of imaging technologies like MRI and transvaginal ultrasound has made early diagnosis more practical, enabling treatment planning that preserves fertility and earlier intervention.

In the past, hysterectomy represented as gold standard regarding final treatment of adenomyosis. However, this surgical treatment prohibits women to become pregnant in the near future. Due to this restriction, focus has shifted to less invasive, uterus-sparing procedures. Of these, hysteroscopic methods most notably, end myometrial excision and localized lesion ablation have attracted a lot of interest. Restoring the uterine cavity's structure and function, reducing discomfort, and above all improving fertility and pregnancy outcomes are the goals of these surgical confrontations.

With an emphasis on fertility and obstetric outcomes, this thorough narrative review assesses the available data on hysteroscopic therapy of adenomyosis. Using the terms adenomyosis, hysteroscopy, pregnancy, infertility, treatment and outcomes, a comprehensive search of English-language literature from 2000 to 2025 was carried out, incorporating clinical trials, cohort studies, and systematic reviews from PubMed, Scopus, and Google Scholar. Excluded were studies with no particular reproductive outcome data or that focused on other surgical modalities (laparoscopy, hysterectomy).

Keywords:

Adenomyosis, Hysteroscopy, Pregnancy rate, Doppler ultrasound, MRI.

Funding

None

Refernces

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