4. Adenomyosis and Endometriosis
In a case-control study it was studies whether there is an association exists between the histopathologic diagnosis of adenomyosis and infertility in a population of captive baboons. Necropsy records of 37 baboons diagnosed with adenomyosis uteri and 38 baboons with normal uterine histology were analysed. A chi2 analysis of the association between adenomyosis, primary infertility, and the presence of coexisting endometriosis was performed. Endometriosis was associated with the presence of adenomyosis There was a trend toward an association of endometriosis with the presence of lifelong infertility, but this correlation did not quite achieve statistical significance. Adenomyosis was associated with the presence of lifelong infertility. This association was maintained when cases of coexisting endometriosis (n = 17) were excluded. It is concluded that adenomyosis is strongly associated with lifelong primary infertility in the baboon, even in the absence of coexisting endometriosis.
Comment by Ferticonsult: This is confirming data that have been published by the group of G. Leyendecker (Darmstadt), particularly:
Leyendecker G, Kunz, G, Noe, M, Herbertz, M, Mall G (1998)
Endometriosis: A dysfunction and disease of the archimetra. Hum. Reprod. Update 4:752-762
Kunz G, Beil D, Huppert P, Leyendecker G (2000) Structural abnormalities of the uterine wall in women with endometriosis and infertility visualised by vaginal
sonography and magnetic resonance imaging. Hum. Reprod. 15:76-82
Leyendecker G, Herbertz M, Kunz G, Mall G. (2002) Endometriosis results from the dislocation of basal endometrium. Hum. Reprod. 17: 2725-2736
Leyendecker and co-workers consider endometriosis and adenomyosis as variants of the same disease process. This is now also demonstrated in the baboon.
Barrier BF, Malinowski MJ, Dick EJ Jr, Hubbard GB, Bates GW. Adenomyosis in the baboon is associated with primary infertility. Fertil Steril. 2004 Oct;82 Suppl 3:1091-4.