Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyendecker G
Department of Obstetrics and Gynaecology, Academic Teaching Hospital to the Universities of Frankfurt and Heidelberg/Mannheim, Klinikum Darmstadt, Darmstadt, Germany.
Hum Reprod. 2005 Aug;20(8):2309-16. doi: 10.1093/humrep/dei021. Epub 2005 May 26.
The hypothesis is tested that there is a strong association between endometriosis and adenomyosis and that adenomyosis plays a role in causing infertility in women with endometriosis. METHODS. Magnetic resonance imaging of the uteri was performed in 160 women with and 67 women without endometriosis. The findings were correlated with the stage of the disease, the age of the women and the sperm count parameters of the respective partners.
The posterior junctional zone (PJZ) was significantly thicker in women with endometriosis than in those without the disease (P<0.001). There was a positive correlation of the diameter of the PJZ with the stage of the disease and the age of the patients. The PJZ was thicker in patients with endometriosis with fertile than in patients with subfertile partners. The prevalence of adenomyotic lesions in all 160 women with endometriosis was 79%. In women with endometriosis below an age of 36 years and fertile partners, the prevalence of adenomyosis was 90% (P<0.01)
With a prevalence of up to 90%, uterine adenomyosis is significantly associated with pelvic endometriosis and constitutes an important factor of sterility in endometriosis presumably by impairing uterine sperm transport.
对子宫内膜异位症与子宫腺肌病之间存在强关联以及子宫腺肌病在导致子宫内膜异位症女性不孕中起作用这一假说进行了检验。方法：对160例患有子宫内膜异位症的女性和67例未患子宫内膜异位症的女性进行了子宫磁共振成像检查。研究结果与疾病分期、女性年龄以及各自伴侣的精子计数参数相关。
患有子宫内膜异位症的女性的子宫后联合区（PJZ）明显比未患该病的女性厚（P<0.001）。PJZ直径与疾病分期和患者年龄呈正相关。子宫内膜异位症患者中配偶生育能力正常者的PJZ比配偶生育能力低下者的厚。160例患有子宫内膜异位症的女性中子宫腺肌病病变的患病率为79%。在年龄低于36岁且配偶生育能力正常的子宫内膜异位症女性中，子宫腺肌病的患病率为90%（P<0.01）。
子宫腺肌病患病率高达90%，与盆腔子宫内膜异位症显著相关，并可能通过损害子宫精子运输而成为子宫内膜异位症不孕的一个重要因素。
