Page 66 - ESHRE2019

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1. Smooth muscle hyperplasia with ectopic endometrium (junctional zone)
2. Micro‐dilated ectopic endometrial glands throughout hyperplastic myometrium
Diffuse adenomyosis
Focal adenomyosis
Polypoid adenomyosis
Special categories
1. Adenomyomas
2. Cystic adult adenomyosis
2a. Juvenile cystic adenomyosis
1. Typical polypoid adenomyomas 2. Atypical polypoid adenomyomas
1. Adenomyomas of endocervical type 2. Retroperitoneal adenomyosis
or rectovaginal endometriosis
Grimbizis et al, Fertil Steril, , 2013
Bird et al. 1972 AJOG
Levgur et al 2000 Obst & Gynec
Kishi et al.: 2012 AJOG
Gordts et al. 2008 RBMonline
Pistofidis 2014 Clin Exp Obstet Gynecol
Grimbizis 2014 Fertil Steril
Grade I: subbasal endometrium Grade II: mid myometrium
Grade III: behind mid myometrium
Superficial: < 40% uterine wall Intermediate: depth between 40‐80% Deep: > 80% uterine thickness
Intrinsic: inner uterine layer
Extrinsic: outer uterine layer (JZ normal) Intramural: solitary adenomyosis Indeterminate
JZ hyperplasia: 8‐12mm Adenomyosis: > 12 mm adenomyoma
Diffuse, sclerotic, nodular, cystic
Diffuse, focal, polypoid, special
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