Adenomyosis predicts impaired uterotubal transport in endometriosis

September 2006

Researchers reveal that many endometriosis patients, particularly those with concomitant adenomyosis, have their uterotubal transport impeded by hyperperistalsis or dysperistalsis

Stefan Kissler, who led the research team at the Johann-Wolfgang-Goethe University at Frankfurt-am-Mainn in Germany, explains that the extent of the adenomyotic component in women with endometriosis explains much of the reduced fertility in women with intact tubo-ovarian anatomy.

Hyperperistalsis and dysperistalsis of the uterus are already known to be common in endometriosis patients and thought to contribute to their poor fertility. The researchers therefore set out to establish whether these phenomena are caused by endometriosis itself or the adenomyotic component of the disease.

Of the 41 endometriosis patients included in the study, 35 showed evidence of adenomyosis on T2-weighted magnetic resonance imaging. Further examination of the patients with hysterosalpingography showed that that two (33 percent) of the six with no adenomyosis had dysperistalsis and hyperperistalsis, compared with 14 (58 percent) of the 24 with focal adenomyosis and 10 (91 percent) of the 11 with diffuse adenomyosis.

Wherease this is a relatively small study, the researchers are able to propose that that “endometriosis is associated with impeded hyperperistaltic and dysperistaltic uterotubal transport capacity. However, adenomyosis is of even more importance, especially when diffuse adenomyosis is detected.”


Kissler S, Hamscho N, Zangos S, Wiegratz I, Schlichter S, Menzel C, Doebert N, Gruenwald F, Vogl TJ, Gaetje R, Rody A, Siebzehnruebl E, Kunz G, Leyendecker G, Kaufmann M. Uterotubal transport disorder in adenomyosis and endometriosis–a cause for infertility. BJOG 2006;113(8):902-8.

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