Severe pain, heavy bleeding, and a uterus that actively resists embryo implantation. Adenomyosis is a profoundly complex diagnosis, but with ultra-long downregulation IVF protocols, pregnancy is absolutely possible.
In a normal uterus, the inner lining (the endometrium) thickens and sheds every month. In adenomyosis, this glandular tissue breaks through the boundary and begins growing *deep inside the muscular wall* of the uterus itself.
Every time your period comes, this trapped tissue bleeds inside the muscle wall, causing the uterus to become enlarged, incredibly painful (often described as feeling "boggy" or like a bruise), and highly inflamed.
While Endometriosis is the growth of lining tissue *outside* the uterus (on the ovaries, tubes, or bowel), Adenomyosis is the growth of that tissue *inside* the muscular wall of the uterus itself. Many patients suffer from both simultaneously.
Adenomyosis is notoriously difficult to diagnose on a basic ultrasound. We rely on high-fidelity MRI (Magnetic Resonance Imaging) of the pelvis to measure the "Junctional Zone" thickness and definitively diagnose the condition before attempting an embryo transfer.
You cannot implant an embryo into a bleeding, angry muscle. Our clinical strategy in Lahore revolves around completely "turning off" the inflammation before we attempt an IVF transfer.
We start by stimulating the ovaries to retrieve eggs, fertilizing them via ICSI, and fast-freezing (vitrifying) all resulting high-quality embryos. We do not transfer yet.
We use potent GnRH agonists (like Lupron/Zoladex) for 2 to 3 months. This essentially induces a temporary medical menopause. Without estrogen fueling it, the adenomyosis shrinks, the bleeding stops, and the uterine muscle heals.
Once MRI or ultrasound confirms the uterus is quiet, tight, and inflammation-free, we carefully prepare the inner lining with specialized medication and thaw a frozen embryo for transfer into the newly optimized environment.