Reply: Adenomyosis in endometriosis - prevalence and impact on fertility. Evidence from magnetic resonance imaging

摘要

Sir,We thank the authors for their interest in our work. The bulk of the MR imaging scans of our study was obtained during 1999 through 2001. That is why we used the same MRI method as described in our publication of 2000 (Kunz et al, 2000). With this method, high quality scans were obtained (Figures 1 and 4 of our paper) (Kunz et al., 2005) which allowed us to identify alterations of the junctional zone that were interpreted as signs of focal and diffuse adenomyosis, respectively, according to the data of Reinhold et al. (1999). We were even more cautious in that a threshold value of more than 10 mm was chosen above which, with additional signs up to 12 mm, diffuse adenomyosis was assumed.but rather with a variable time interval with endometriosis usually coming first and followed by adenomyosis as the main determinant with respect to infertility. Thus, in this dynamic process of disease development no static value for the prevalence of adenomyosis in endometriosis can be expected. This value varies dependent on the study population chosen. In our study, all patients or couples including the 'healthy, and 'total controls' were suffering from infertility and were seeking treatment by assisted reproduction, increasing the probability that both the peritoneal and the uterine variant of the disease had developed in these women.