{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T17:19:47Z","timestamp":1771262387770,"version":"3.50.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T00:00:00Z","timestamp":1727308800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Adenomyosis-related infertility is increasingly being diagnosed, and surgical intervention has been suggested to improve fertility. Elastography, a noninvasive ultrasound technique, is promising for diagnosing and guiding the resection of adenomyosis. This report presents the first case of successful delivery after twin pregnancies achieved with IVF following intraoperative elastography-guided laparoscopic adenomyomectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 35-year-old Japanese woman with uterine adenomyosis received a gonadotropin analog before surgery. Preoperative MRI revealed a 5.0 \u00d7 7.0\u2009cm adenomyoma, leading to scheduled laparoscopic adenomyomectomy with intraoperative elastography. During surgery, elastography ensured the complete resection of the adenomyotic tissue while preserving the endometrium. Postoperative MRI confirmed the absence of residual adenomyosis. The patient underwent <jats:italic>in vitro<\/jats:italic> fertilization and embryo transfer, leading to a successful twin pregnancy after double blastocyst transfer. Despite a stable perinatal course, she required hospitalization to prevent preterm labor. At 32\u2009weeks, an elective cesarean section delivered healthy twins. The intra- and post-operation was uncomplicated, and the patient and infants had an optimal health.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first reported case of a twin pregnancy resulting from vitrified-warmed embryo transfer after elastography-guided laparoscopic adenomyomectomy, culminating in a successful delivery via cesarean section. This technique allows precise resection and mitigates the risks of uterine rupture and placenta accreta spectrum disorders. Although promising, further studies are required to validate the safety and efficacy of this innovative surgical approach.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1457611","type":"journal-article","created":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T04:38:59Z","timestamp":1727325539000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Case Report: The first case of successful pregnancy and live birth following laparoscopic resection of adenomyosis under real-time intraoperative ultrasound elastography guidance"],"prefix":"10.3389","volume":"11","author":[{"given":"Yoshiaki","family":"Ota","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniaki","family":"Ota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshifumi","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naoki","family":"Horikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryosuke","family":"Kuroda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hana","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoyuki","family":"Kusumoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Oda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takehiko","family":"Matsuyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takahito","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuro","family":"Honda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichiro","family":"Shimoya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,9,26]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"374","DOI":"10.1093\/humupd\/dms006","article-title":"Adenomyosis and subfertility: a systematic review of prevalence, diagnosis, treatment and fertility outcomes","volume":"18","author":"Maheshwari","year":"2012","journal-title":"Hum Reprod Update"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/j.fertnstert.2023.03.018","article-title":"Association of endometriosis and adenomyosis with pregnancy and infertility","volume":"119","author":"Vercellini","year":"2023","journal-title":"Fertil Steril"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1097\/GCO.0b013e3282f1bf00","article-title":"Transvaginal ultrasound or MRI for diagnosis of adenomyosis","volume":"19","author":"Dueholm","year":"2007","journal-title":"Curr Opin Obstet Gynecol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"3410","DOI":"10.3390\/jcm10153410","article-title":"Current and prospective treatment of adenomyosis","volume":"10","author":"Sharara","year":"2021","journal-title":"J Clin Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"635","DOI":"10.1016\/j.tjog.2015.05.003","article-title":"Conservative surgical treatment of adenomyosis to improve fertility: controversial values, indications, complications, and pregnancy outcomes","volume":"54","author":"Tsui","year":"2015","journal-title":"Taiwanese J Obstet Gynecol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1007\/s00404-017-4603-6","article-title":"Surgery in adenomyosis","volume":"297","author":"Oliveira","year":"2018","journal-title":"Arch Gynecol Obstet"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1016\/j.jmig.2023.03.015","article-title":"Pregnancy outcomes after uterus-sparing operative treatment for Adenomyosis: a systematic review and Meta-analysis","volume":"30","author":"Jiang","year":"2023","journal-title":"J Minim Invasive Gynecol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"2531","DOI":"10.3390\/jcm13092531","article-title":"The impact of conservative surgical treatment of Adenomyosis on fertility and perinatal outcomes","volume":"13","author":"Moawad","year":"2024","journal-title":"J Clin Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1093\/humupd\/dmz049","article-title":"Diagnosing adenomyosis: an integrated clinical and imaging approach","volume":"26","author":"Chapron","year":"2020","journal-title":"Hum Reprod Update"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1235","DOI":"10.3390\/ijerph18031235","article-title":"Adenomyosis and infertility-review of medical and surgical approaches","volume":"18","author":"Szubert","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1016\/j.tjog.2021.09.010","article-title":"Minimally invasive adenomyomectomy via a laparoscopic-assisted approach compared to a laparoscopic or laparotomic approach","volume":"60","author":"Ahn","year":"2021","journal-title":"Taiwanese J Obstet Gynecol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1111\/jog.13658","article-title":"Conservative surgery of uterine adenomyosis via laparoscopic versus laparotomic approach in a single institution","volume":"44","author":"Kwack","year":"2018","journal-title":"J Obstet Gynaecol Res"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1093\/humupd\/4.4.323","article-title":"Surgical and medical treatment of adenomyosis","volume":"4","author":"Wood","year":"1998","journal-title":"Hum Reprod Update"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.jmig.2017.07.014","article-title":"Conservative surgery for adenomyosis and results: a systematic review","volume":"25","author":"Younes","year":"2018","journal-title":"J Minim Invasive Gynecol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s12958-023-01145-y","article-title":"Application of elastography to diagnose adenomyosis and evaluate the degree of dysmenorrhea: a prospective observational study","volume":"21","author":"Ren","year":"2023","journal-title":"Reprod Biol Endocrinol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1016\/j.ultrasmedbio.2022.11.006","article-title":"Ultrasound Elastography for the diagnosis of endometriosis and Adenomyosis: a systematic review with Meta-analysis","volume":"49","author":"Brunelli","year":"2023","journal-title":"Ultrasound Med Biol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"e04628","DOI":"10.1016\/j.heliyon.2020.e04628","article-title":"New surgical technique of laparoscopic resection of adenomyosis under real-time intraoperative ultrasound elastography guidance: a case report","volume":"6","author":"Ota","year":"2020","journal-title":"Heliyon"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"707","DOI":"10.3390\/jcm11226707","article-title":"Laparoscopic Adenomyomectomy under real-time intraoperative ultrasound Elastography guidance: a case series and feasibility study","volume":"11","author":"Ota","year":"2022","journal-title":"J Clin Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"348","DOI":"10.3390\/endocrines2030032","article-title":"A case of elastography-assisted laparoscopic fertility preservation for severe deep endometriosis causing ureteral stenosis and subtype II adenomyosis","volume":"2","author":"Ota","year":"2021","journal-title":"Endocrine"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1002\/ijgo.14635","article-title":"Maintenance dienogest therapy following adjuvant gonadotropin-releasing hormone agonist treatment after uterus-sparing surgery in adenomyosis: a retrospective cohort study","volume":"161","author":"Chan","year":"2023","journal-title":"Int J Gynecol Obstet"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1097\/00001703-199906000-00013","article-title":"Culture and transfer of human blastocysts","volume":"11","author":"Gardner","year":"1999","journal-title":"Curr Opin Obstet Gynecol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1186\/s12884-022-05241-6","article-title":"A case of discrepancy between three ERA tests in a woman with repeated implantation failure complicated by chronic endometritis","volume":"22","author":"Ota","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1016\/j.fertnstert.2014.05.028","article-title":"Who will benefit from uterus-sparing surgery in adenomyosis-associated subfertility?","volume":"102","author":"Kishi","year":"2014","journal-title":"Fertil Steril"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1016\/j.rbmo.2014.02.008","article-title":"Treatment of adenomyomectomy in women with severe uterine adenomyosis using a novel technique","volume":"28","author":"Saremi","year":"2014","journal-title":"Reprod Biomed Online"},{"key":"ref25","first-page":"69","article-title":"Shikyusenkinshokakushutsujutsu-go ninshin-ji no shikyuharetsu-yobo ni tsuite (prevention of uterine rupture during pregnancy after adenomyomectomy)","volume":"27","author":"Nishida","year":"2016","journal-title":"Obstet Gynecol Surg (Tokyo Medical View)"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1016\/j.jmig.2005.12.002","article-title":"Kudo M, Minakami H. Spontaneous uterine rupture of a twin pregnancy after a laparoscopic adenomyomectomy: a case report","volume":"13","author":"S-i","year":"2006","journal-title":"J Minim Invasive Gynecol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"311","DOI":"10.5468\/ogs.2016.59.4.311","article-title":"Monochorionic twin delivery after conservative surgical treatment of a patient with severe diffuse uterine adenomyosis without uterine rupture","volume":"59","author":"Kwack","year":"2016","journal-title":"Obstet Gynecol Sci"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"175","DOI":"10.14734\/PN.2023.34.4.175","article-title":"Antenatal and delivery outcomes in twin pregnant women after uterine Adenomyomectomy: summary of 5 cases","volume":"34","author":"Kweon","year":"2023","journal-title":"Perinatology"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"9","DOI":"10.13181\/mji.v15i1.208","article-title":"Laparoscopic resection versus myolysis in the management of symptomatic uterine adenomyosis: alternatives to conventional treatment","volume":"15","author":"Hadisaputra","year":"2006","journal-title":"Med J Indones"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1016\/j.jmig.2010.04.015","article-title":"Risk factors for uterine rupture after laparoscopic myomectomy","volume":"17","author":"Parker","year":"2010","journal-title":"J Minim Invasive Gynecol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.ajog.2008.08.063","article-title":"Laparoscopy vs laparoscopically assisted myomectomy in the management of uterine myomas: a prospective study","volume":"200","author":"Prapas","year":"2009","journal-title":"Am J Obstet Gynecol"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"762","DOI":"10.1016\/j.jmig.2012.07.003","article-title":"Report of 7 uterine rupture cases after laparoscopic myomectomy: update of the literature","volume":"19","author":"Pistofidis","year":"2012","journal-title":"J Minim Invasive Gynecol"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1111\/ajo.12419","article-title":"Association of uterine wall thickness with pregnancy outcome following uterine-sparing surgery for diffuse uterine adenomyosis","volume":"56","author":"Otsubo","year":"2016","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"4145","DOI":"10.1080\/14767058.2019.1597845","article-title":"Perinatal outcome of pregnancy after adenomyomectomy: summary of 10 cases with a brief literature review","volume":"33","author":"Sugiyama","year":"2020","journal-title":"J Matern Fetal Neonatal Med"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"100265","DOI":"10.1016\/j.xagr.2023.100265","article-title":"Possible risks and benefits of adenomyomectomy on pregnancy outcomes: a retrospective analysis","volume":"3","author":"Sayama","year":"2023","journal-title":"AJOG Glob Rep"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1111\/1471-0528.12717","article-title":"Uterine sutures at prior caesarean section and placenta accreta in subsequent pregnancy: a case-control study","volume":"121","author":"Sumigama","year":"2014","journal-title":"BJOG"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"221","DOI":"10.4103\/gmit.gmit_146_21","article-title":"Influence of uterine cavity breach in laparoscopic myomectomy on the risk of obstetric complications","volume":"11","author":"Wada","year":"2022","journal-title":"Gynecol Minim Invasive Ther"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"1346","DOI":"10.1177\/1933719117691141","article-title":"Molecular characteristics of the endometrium in uterine Adenomyosis and its biochemical microenvironment","volume":"24","author":"Yen","year":"2017","journal-title":"Reprod Sci"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.placenta.2012.11.017","article-title":"Defective myometrial spiral artery remodelling as a cause of major obstetrical syndromes in endometriosis and adenomyosis","volume":"34","author":"Brosens","year":"2013","journal-title":"Placenta"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.1111\/jog.12088","article-title":"Time spatial labeling inversion pulse magnetic resonance angiography in pregnancy with adenomyosis","volume":"39","author":"Yorifuji","year":"2013","journal-title":"J Obstet Gynaecol Res"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"211","DOI":"10.4103\/gmit.gmit_45_22","article-title":"Effectiveness of laparoscopic Adenomyomectomy on perinatal outcomes","volume":"12","author":"Ono","year":"2023","journal-title":"Gynecol Minim Invasive Ther"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"8","DOI":"10.12688\/f1000research.17242.1","article-title":"Recent advances in understanding and managing adenomyosis","author":"Vannuccini","year":"2019","journal-title":"F1000Res"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"102507","DOI":"10.1016\/j.bpobgyn.2024.102507","article-title":"Conservative surgical treatment for adenomyosis: new options for looking beyond uterus removal","volume":"95","author":"Capezzuoli","year":"2024","journal-title":"Best Pract Res Clin Obstet Gynaecol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1457611\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T04:39:02Z","timestamp":1727325542000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1457611\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,26]]},"references-count":43,"alternative-id":["10.3389\/fmed.2024.1457611"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1457611","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,26]]},"article-number":"1457611"}}