Antoine Jean-Marie Maubon MD, Presenter: Nothing to Disclose

Pascal Piver MD, Abstract Co-Author: Nothing to Disclose

Benedicte Caire-Gana, Abstract Co-Author: Nothing to Disclose

Michel Kapella, Abstract Co-Author: Nothing to Disclose

Jerome Gana, Abstract Co-Author: Nothing to Disclose

Jean Pierre Rouanet de lavit, Abstract Co-Author: Nothing to Disclose

Adenomyosis is defined by the presence of ectopic endometrium within the myometrium. Adenomyosis is considered a factor of infertility. MRI allows a non invasive diagnosis of adenomyosis. Our goal was to determine whether pelvic MRI can help in identifying adenomyosis as a factor of infertility.

Prospective study by pelvic MRI of infertile patients included in an IVF program, before IVF or embryo transfer. Pelvic MRI at 1.5T, with T2 and T1 fat sat sequences. Identification of adenomyosis (definite, possible, absent), measurements of junctional zone thickness (anterior, posterior, fundus) to determine the average (AJZ) and maximum (MJZ) junctional zone thickness. Correlation with IVF results (implantation and pregnancy rates).

97 patients (100 MRI) were included for a total of 167 embryo transfers. Adenomyosis was detected by MRI in 35% of patients. AJZ and MJZ are factors independent of patients age. Statistically significant differences were noted concerning: pregnancy rates (37% versus 60%, p=0.002), number of transfer per patient (1.5 versus 1.8, p=0.004). AJZ >7mm and MJZ >11mm are associated with the lowest rates of pregnancy per patient (5% versus 62%, p=0.0001) and pregnancy per transfer (3% versus 39%, p=0.0001)

A thickened junctional zone at pelvic MRI is a factor of implantation failure in an IVF population. MRI could be used as a screening tool in this population to identify patients requiring additional treatment.

Maubon, A, Piver, P, Caire-Gana, B, Kapella, M, Gana, J, Rouanet de lavit, J, Pelvic MRI of Infertile Patients Included in an IVF Program: Implantation Failure Is Linked to Uterine Junctional Zone Thickness.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4405563.html