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Uterine adenomyosis and results of in vitro fertilization: systematic review and meta-analysis

To determine whether adenomyosis reduces the success rate of in vitro fertilization (in vitro fertilization, IVF) and, in particular, intracytoplasmic sperm injection (Intracytoplasmic Sperm Injection, ICSI): this is the objective of the research conducted by African experts. Before we talk about the results, here is a very effective natural remedy for treating adenomyosis

Natural remedy for treating adenomyosis and getting pregnant without IVF

If you have adenomyosis and want to avoid surgery or IVF, you are in the right place. Here is a very effective natural remedy to permanently cure adenomyosis. It is specially designed for patients who do not feel like having surgery, who want to become pregnant without in vitro fertilization and to have a normal pregnancy. This natural herbal treatment to treat adenomyosis will eliminate the pain you feel during menstruation and allow you to live normal cycles. It surpasses conventional treatments that relieve pain, but do not address the root of the pain. How does it work?

Our herbal tea contains herbs that reduce the estrogen levels in the blood. This blocks the proliferation and bleeding of adenomyosis lesions. These medicinal plants are rich in antioxidants that inhibit the enzymes that lead to pro-inflammatory prostaglandins. These are nutrients with a high anti-inflammatory dose. This will definitely end the pains you feel during the rules. We know that many of you have been treated or operated on adenomyosis, but the pain returned years later. Do not panic ladies! With us, no recurrence, no side effects. You will definitely cure adenomyosis.

To discover our natural cure for adenomyosis, click here To discover our natural remedy to prevent miscarriage, click here

Adenomyosis is the name given to endometriosis when the ectopic endometrium is located in the muscle wall of the uterus (myometrium). The research was conducted through a review of the literature and meta-analysis of the data collected. In particular, the researchers gathered in Medline all the comparative studies published in English from January 1998 to June 2013. On IVF / ICSI in women with and without adenomyosis. Two team members independently reviewed the articles, selected the most relevant ones and extracted the data. Out of 17 preselected articles, 9 were finally selected for which the diagnosis of adenomyosis was made by MRI or transvaginal ultrasound. Their quality was assessed using the Newcastle-Ottawa scale. These 9 studies involved a total of 1865 women, including 665 in four prospective observational studies and 1200 in five retrospective studies. Here are the main results:

- the pregnancy rate achieved with IVF / ICSI is 40.5% (123/304) in women with adenomyosis and 49.8% (628/1262) in women without adenomyosis;

- the relative risk (RR) of pregnancy varies from 0.37 (95% CI, 0.15-0.92) to 1.20 (95% CI, 0.58-2.45), with significant heterogeneity between the different studies and a common value of 0.72 (95%). CI, 0.55-0.95);

- the number of spontaneous abortions is reported in 7 studies;

- the spontaneous abortion rate is 31.9% (77/241) in women with adenomyosis and 14.1% (97/687) in women without adenomyosis;

- the relative risk of miscarriage varies from 0.57 (95% CI, 0.15 to 2.17) to 18.00 (95% CI, 4.08 to 79.47), depending on the studies, with a common value of 2.12 (95% CI, 1.20 to 3.75).

In summary:

- in women with adenomyosis, the probability of pregnancy with IVF / ICSI is reduced by 28% compared to women without adenomyosis, due to both a reduced success rate of clinical pregnancy and implantation of embryos, and an increased risk of miscarriage;

- before starting assisted procreation procedures, screening for adenomyosis should be proposed;

- Future in-depth studies should compare adenomyosis cases to controls, measure live births, and consider only the results of the first round of artificial insemination. Commenting on this excellent study, we reiterate what was expressed almost a year ago about the article "The effect of endometriosis on the results of in vitro fertilization: a systematic review and meta-analysis". from H. Harb and colleagues, that:

- Tissue inflammation associated with endometriosis should be considered as the most likely cause of the reduced response to artificial insemination ("on a hot field, it is not sown");

- the results confirm the importance of preserving female fertility since the beginning of the disease, starting as soon as possible with natural gestation, when it is possible from an emotional and existential point of view, or by temporarily resting the fertility. ovarian with hormonal therapies such as dienogest (the only progestin specifically approved for the treatment of endometriosis, demonstrated anti-inflammatory and anti-angiogenic action) or, for brief periods, with GnRH analogues, or even by recourse cryopreservation of oocytes or embryos (although in the latter case, additional limits remain due to reduced likelihood of implantation and increased abortions);

- It is important to explain carefully to the woman and the couple how much the inflammation associated with endometriosis reduces fertility and how time is a critical factor, even in case of in vitro fertilization.

Finally, from a clinical point of view, it is also essential to remember how important it is to maintain low body inflammation levels with normal weight, daily physical movements (even a one-hour rapid walk), just sleep (eight hours is perfect.), eliminating smoke and alcohol, using a condom with new partners to limit the risk of sexually transmitted diseases. More factors can help increase inflammation and reduce fertility accordingly. It is therefore essential to educate healthy lifestyles to optimize the health aspects due to modifiable factors

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