Adenomyosis is a condition where tissue similar to the uterine lining grows inside the muscular wall of the uterus. For years, doctors treated it as one single problem. But a new look at nine studies suggests the location of this tissue might change how it affects your ability to have a baby. The research compared two types: intrinsic adenomyosis, which stays inside the uterine muscle, and extrinsic adenomyosis, which extends outward.
The findings reveal a clear difference in how these two types impact fertility. Women with extrinsic adenomyosis were much more likely to experience primary infertility and had a higher prevalence of endometriosis, with association rates reaching up to 89%. In contrast, women with intrinsic adenomyosis faced a stronger link to recurrent pregnancy loss and secondary infertility. This means the specific pattern of the disease tells a different story about what might be blocking a pregnancy.
However, we must be careful not to overstate what we know. The data on assisted reproduction treatments, like IVF, remains very limited. The studies used different definitions for the disease, making it hard to compare results perfectly. Because the evidence is based on observation rather than controlled experiments, we see correlations but cannot prove that one type directly causes the other. Until more research is done, these findings should guide conversations but not replace personalized medical advice.