First of all, adenomyosis can affect fertility. Secondly, patients should not be discouraged because there are many patients with adenomyosis who have successfully conceived and given birth to babies during the course of their disease. There are several causes of infertility due to adenomyosis: First, it affects the uterine environment. This is one of the most common causes of adenomyosis lesions that cause the uterine environment to become very poor. For example, affected by adenomyosis, the patient will have a larger uterus, thickened uterine wall, uterine polyps and other problems, which makes the environment for fertilized eggs to be laid very poorly and not develop properly. Therefore, many patients with adenomyosis will have their embryos stop developing after a few months of pregnancy, and there is no fetal heart or fetal bud on ultrasound, making them suffer from the pain of losing a child. Secondly, it causes the fallopian tubes to be blocked. Another common reason is that the location of the lesion is close to the fallopian tube, which compresses the fallopian tube and causes it to become blocked and inaccessible, so that sperm and eggs cannot meet and naturally, pregnancy is not possible. Third, inflammation. Inflammation is also the cause of tubal adhesions and obstruction. Some patients with adenomyosis do not have a poor uterine environment, but some aseptic inflammatory diseases caused by adenomyosis, or some inflammatory diseases that the patient has had, cause adhesions and obstruction of the fallopian tubes, which in turn cause infertility. Combined cochlear cysts. The combination of coeliacs may also lead to infertility. It is very common for adenomyosis to be combined with chocolate cysts. If the cysts are large or multifaceted, they can affect the ovarian ovulation function, and poor ovulation can lead to infertility. Therefore, for patients with adenomyosis who are infertile, what is the condition of adenomyosis? Are the fallopian tubes open or not? What is the state of the ovaries? These three aspects must be checked clearly. Regarding the infertility test: First of all, check the male partner! Remember, remember!!! Infertility may not always be due to the female partner, but it may also be due to the male partner. Therefore, it is important to avoid doing only one-sided tests. The man should first go for a routine semen test, which is painless and not much work. When the male partner is found to be fine, then the female partner is examined. When examining the female partner, a tubal imaging test (usually 3-7 days after menstruation) can be done first for adenomyosis. This is done to see if there are adhesions in the fallopian tubes and if they are open. If the fallopian tubes are open and the ovaries are free of coarctation, then the lack of pregnancy is due to adenomyosis. If the fallopian tubes are found to be incompetent after imaging, then the infertility symptoms may also be due to blocked fallopian tubes. What should I do in this case? If the patient’s uterus is not very large (not larger than 7cm), a simple laparoscopic surgery can be done at this time, but of course this minimally invasive surgery is not to treat adenomyosis, but to unblock the fallopian tubes. At the same time, some individual distinct adenomyosis lesions can be destroyed by high-frequency electrocoagulation. Although this cannot cure adenomyosis, it will increase the patient’s chances of pregnancy after surgery. What should I do if the infertility is caused by coeliacs? It depends on the size of the coeliac sac, if it is not bigger than 4 cm and you have not been able to conceive, at this time we can consider IVF. In short, if you have adenomyosis and want to have a baby, you should try to conceive as soon as possible, don’t wait, the later you wait, the less likely you will conceive. If you can conceive naturally, it is best to consider IVF if you cannot conceive naturally. In addition, adenomyosis patients are fortunate enough to be pregnant and must do a good job of keeping the baby alive.