Adenomyosis is essentially nothing more than the proliferation of cells of the functional layer of the uterus in other tissues of the female body. Pathology occurs quite often, especially in reproductive age. Many are afraid of this problem, because they believe that adenomyosis and pregnancy are incompatible, or pregnancy with adenomyosis of the uterus will proceed with various complications, which will adversely affect both the health of the fetus and women.
General Information
The normal mucous membrane of the uterus, which lines it from the inside, is clearly delineated from the muscular. Particles of the endometrium can enter the walls of the uterus under the influence of hormonal imbalance, operations on the reproductive organs or various infectious processes. As a consequence, the following symptoms occur:
- Breaking the menstrual cycle - it can lengthen, but it usually shrinks;
- The amount of excretions increases during menstruation, and menstruation begins to last longer;
- The onset and end of menstruation is accompanied by a swelling;
- Pain increases during menstruation, and they also appear at other times.
These clinical manifestations indicate a violation of the hormonal background of the female body. That is why most women believe that adenomyosis of the uterus and pregnancy are completely incompatible concepts.
Reality of pregnancy
One of the most common complications of adenomyosis is infertility, as the muscular layer of the uterus loses its functionality due to the inclusion of mucosal cells. Some women can not conceive a child, another part is not able to bear it. Sometimes the obstruction of the fallopian tubes can develop, because of which the egg can not simply be fertilized. Also, there may be an increased contractility of the uterus, due to the presence of foreign cells in its muscle layer. The consequence of this is usually the deterioration or impossibility of implantation into the uterus of the egg. That is why the question "Is it possible to become pregnant with adenomyosis of the uterus?" Is extremely relevant for so many women.
There are a number of reasons that prevent the onset of this long-awaited moment:
- The basis of the disease lies in the fact that the mucous membrane of the uterus gets into the muscular tissues of the organ, punching the border between them. Thus, in some places of the muscle layer, atypical cells begin to grow, which negatively affects the work of both the uterus itself and the surrounding organs. With the spread of pathology on the fallopian tubes, the answer to the question "is pregnancy possible" will definitely be "no".This is due to the formation of adhesions leading to obstruction and inability to fertilize the egg.
- Development of severe hormonal imbalance. As a result, the growth of the endometrium, the maturation of the egg cell is disrupted. Clinically, the violation of the hormonal background is manifested by the irregularity of the monthly, their lengthening, the development of pronounced painful omissions.
- Adenomyosis can significantly reduce the defenses of the body. A consequence of this can be neutralization of spermatozoa because the female body recognizes them as alien agents. The same process occurs with the embryo, which can be rejected before the moment of implantation, which interrupts pregnancy at an early stage.
- The contractility of the uterus increases significantly. Even with the successful passage of the first stage of conception and implantation, there are risks for the course of pregnancy. Because of hyper-contraction of the muscular fibers of the uterus, the fetal egg can be rejected or the pregnancy can die off at a later date. A frozen pregnancy, in turn, will lead to an operative intervention or a fruit-destroying operation if it has not been diagnosed in time.
- More often than in half of cases of adenomyosis, a woman suffers from other gynecological pathologies. Among them, quite often there are fibroids, polycystic ovaries, inflammatory processes of the genitals and uterus, which can also interfere with pregnancy.
- The deterioration of the quality of sexual life due to pain and decreased sexual desire.
Given all of the above factors, the onset of pregnancy with adenomyosis is problematic enough. However, it is still possible, as evidenced by the testimonies of those who become pregnant with adenomyosis. Doctors and gynecologists also argue that this is possible. However, the problem requires intervention, not complete inaction.
How to get pregnant
Get a clear answer to the question "how to get pregnant with adenomyosis?" Is quite difficult. The best advice is getting rid of the disease. Given that the cause of the disease has not yet been identified, then the treatment, which will guarantee complete disposal of the problem, is impossible. There is only 1 way to eliminate the pathology - removal of the uterus. In this case, the onset of pregnancy will also be impossible.
First of all, you need to undergo a comprehensive examination:
- Set the patency of the fallopian tubes;
- Find out the scope of the process;
- Determine the hormonal background;
- Set the ovulation.
Treatment will depend on the results of the examination and the detection of the immediate cause of female infertility. Even if the problem is solved temporarily, there is one chance that the pregnancy will come.
Contraceptive preparations
Pregnancy in adenomyosis may occur after the end of the course of contraceptives( Janine, Yarina).This is strange enough, but oral contraceptives are hormonal means, allowing to restore imbalance. They suppress the internal secretion of the ovaries, and after their cancellation the activity of the organs increases.
IUD can be used for the same purpose, as it inhibits the growth of the endometrium. While she is in the uterus, the endometrium stops actively replicating and the disease recedes.
Hormones
In some cases, it is advisable to take drugs containing sex hormones - Utrozhestan, Dyufaston. They contain analogues of progesterone, allowing to increase the second phase of the cycle. Also, they prevent the reproduction of endometrial cells, as a result of which the foci in the muscle layer regress. Reduced pain and contractility of the uterus, which facilitates implantation of the embryo.
Gonadotropin-releasing hormones - Buserelin, Goserelin allow you to create a so-called artificial menopause. Usually, when they are used, pregnancy occurs in the first cycle, which occurred after the withdrawal of drugs. These substances completely block the work of the ovaries, due to which they seem to "rest".Due to the fact that the egg does not enter the uterus, the endometrium begins to thin out, and menstruation ceases. As a consequence - a decrease in foci of adenomyosis, and after about six months the disease affects pregnancy much less.
Dienogest( Byzanne) reduces the production of estrogens, which affect the growth of the endometrium. At the time of taking the drug, the probability of ovulation is reduced. As a result, the mechanism of action is the same as Buserelin.
Surgical correction methods
Quite often, conservative therapy can go in combination with surgical methods of treating infertility and adenomyosis in particular. In the case of diagnosis of obstruction of the fallopian tubes, it will require intervention aimed at restoring their patency.
Foci of adenomyosis can also be removed by laparoscopic surgery. Sometimes used and hysteroscopy.
Complications of pregnancy
First of all, it should be noted that adenomyosis of the uterus may well be combined with pregnancy. Also, pregnancy in itself is the factor that will allow to reduce manifestations of pathology somewhat, since the endometrium does not develop in these 9 months.
In the hormonal background, there is a predominance of progestins over estrogens, which also positively affects pathology. And in the case of the initial stages of the process, pregnancy can serve as a mechanism for complete cure.
There are certain difficulties during pregnancy, because there is a deficit of progesterone. This can significantly increase the contractile capacity of the uterus, and this, in turn, can lead to the termination of pregnancy through miscarriage. Thinning of the walls of the uterus can provoke its damage in late pregnancy.
In this case, it is necessary to monitor the thickness of its wall through regular ultrasound examination. Also, it is necessary to prepare a woman for the fact that delivery will most likely be performed by a cesarean section.
Adenomyosis can provoke the development of adhesions in the uterus, which can affect the growth and development of the child in such a way that he will have to take a certain position of the body. This moment can also lead to a cesarean section.
Premature detachment of the placenta is quite common, especially in cases where the focus of adenomyosis is located in close proximity to its attachment site. Another problem associated with the placenta due to this disease may be the pathology of blood vessels that feed the fetus, there is a risk of developing fetoplacental insufficiency.
