Adenomyosis in Fertile Women in MUSA Criteria

Application of the Revised Morphological Uterus Sonographic Assessment (MUSA) Criteria to Diagnose Adenomyosis in Fertile Women

1. To estimate the prevalence of adenomyosis in fertile women aged 18-30 years using the revised MUSA ultrasound criteria.
2. To evaluate clinical risk factors that are associated with adenomyosis diagnosis in this population

Adenomyosis is a benign condition characterized by the presence endometrial glands and stroma within the myometrium. Its prevalence varies from 5-70%. The definitive diagnosis of adenomyosis is based mainly on histological assessment of hysterectomy specimens. This led to a concept that adenomyosis affects only parous women between 35-50 years who complain of dysmenorrhea and heavy menstrual bleeding. Magnetic Resonance Imaging (MRI) can detect adenomyosis with a sensitivity of 80%. Transvaginal ultrasound using the revised Morphological Uterus Sonographic Assessment (MUSA) criteria can detect adenomyosis non-invasively at a lower cost. Such advancements in imaging techniques allow studying the prevalence of the disease in wider range of population including young women.

Inclusion Criteria:

• women with regular menstrual cycle attending outpatient clinic for contraception counseling
• age 18 -30 years old

Exclusion Criteria:

• Women on hormonal contraception
• Infertile women
• Associated pathologies like endometriosis, uterine fibroids. and ovarian cysts