Clinical Profile and Management Outcomes of Women with Adenomyosis: A Prospective Review from a Fertility Centre in Nigeria.

Background: Adenomyosis is seen in women with infertility, with a significant impact on their lives. This study aims to evaluate the clinical characteristics, management strategies, and treatment outcomes of women diagnosed with adenomyosis. Methodology: This prospective study, conducted at Alps Hospitals and Diagnostics from June 2021 to December 2024, involved 44 women with adenomyosis. The clinical data were collected, reviewed, and analysed. Results: The mean age of participants was 39.5 ± 5.1 years. Most (77.3%) participants were nulliparous, with a mean duration of infertility of 7.4 ± 4.2 years. The most common (63.6%) presenting symptom was combined dysmenorrhoea and menorrhagia. Ultrasonography identified adenomyosis in 54.5% of cases.Diffuse adenomyosis was seen in 52.3% of women. Myomas were the most common (79.5%) co-existing pelvic pathology. Double-flap adenomyomectomy and wedge resection were done in 54.5% and 29.5% of participants, respectively. 13.6% of participants had medical treatment. Surgical site infection was the most frequent (6.8%) post-operative complication.Double flap adenomyomectomy and wedge resection resulted in reductions in Visual Analogue Scale (VAS) scores for dysmenorrhoea and menorrhagia. There was no significant difference (p-value> 0.05) when both surgical options were compared. GnRH analogues resulted in temporary symptom relief. Three women had positive pregnancy tests following In Vitro Fertilization (IVF), out of which 1 resulted in a live birth and 2 ended in miscarriages. Conclusion: Adenomyosis predominantly affects infertile nulliparous women in the late third decade of life with previous uterine surgeries. Combined menorrhagia and dysmenorrhoea are a common presentation, and conservative surgeries may provide sustained symptom relief with limited improvement in reproduction.