ArticleFrontiers in endocrinology2026
Not all adenomyosis is equal: impact of direct adenomyosis features on live birth after ART cycles in a prospective cohort study.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate whether the presence and type of ultrasound markers of adenomyosis, as defined by MUSA criteria, predict IVF/ICSI outcomes, specifically live birth and pregnancy loss rates. Methods: This single-center prospective cohort study included 314 women aged 18-39 years undergoing their first IVF/ICSI cycle between March 2018 and March 2020. All participants underwent standardized transvaginal ultrasound before treatment. Adenomyosis was diagnosed using MUSA criteria, distinguishing direct markers (myometrial cysts, hyperechogenic islands, echogenic subendometrial lines; Results: Among the adenomyosis group, 71.1% exhibited direct markers. Overall, adenomyosis was associated with reduced live birth per embryo transfer (28.9% vs 40.3%, aOR 0.61, 95% CI 0.34-1.08, Conclusion: Direct ultrasound markers of adenomyosis identify a high-risk reproductive phenotype with substantially reduced live birth and markedly elevated total pregnancy loss risk in IVF/ICSI cycles. The presence and type of ultrasound markers, rather than adenomyosis as a binary diagnosis, should inform patient counseling and individualized treatment planning.
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