PGD - Pre-Implantation Genetic Diagnosis MVR - Microscopic Vasectomy Reversal ART Pregnancy Rates Sheet IVF - In Vitro Fertilization ICSI - Intra Cytoplasmic Sperm Injection Tubal Ligation Reversal Vasectomy Reversal vs. Sperm Injection: Dr. Silber’s Analysis Sperm, Embryo, and Ovarian Tissue Freezing and Storage Understanding Infertility Treatment Statistics Video:  Dr. Silber explains Assisted Reproductive Technology "How To Get Pregnant" - Dr. Silber's book "What’s New in Infertility" - Commentary by Dr. Silber Sperm Aspiration for ICSI Blastocyst Culture Video and Audio Library GIFT - Gamete Intra Fallopian Transfer Video:  Dr. Silber explains Microscopic Vasectomy Reversal Bibliography of Dr. Silber Biography of Dr. Silber Radio:  The biological clock discussed with Joan Hamburg TV:  Ovarian tissue transplantation on Montel Williams Preserving Your Fertility TV:  Antral Follicle Count (egg counting) TV:  Freezing the Biological Clock TV:  How to Find Out Where You Are On Your Biological Clock TV:  Dr. Silber Honors His Early Teacher on NBC News Today Show Dr. Silber explains egg and ovary banking to preserve fertility Whole Ovary Transplant Between Non-identical Sisters - Channel 11 St. Louis News Video Clip Whole Ovary Transplant Between Non-identical Sisters - Fox News St. Louis Video Clip Mini-IVF - Fox News St. Louis Video Clip
The Infertility Center of St. Louis


To get feedback from patients who have undergone treatment at our Center, click here to go to the Patient Comments page.

If you have any questions, you may call us at  (314) 576-1400.

Adenomyosis is a condition where endometrial tissue, i.e., uterine lining cells, are dispersed within the muscle of the uterus. It is essentially "endometriosis" of the uterus. There is no capsule or line of demarcation between adenomyosis and the rest of the uterine muscle, like exists with the more common condition of uterine fibroids, benign muscle tumors of the uterus. Adenomyosis is an intensely painful condition, with incapacitating pain during menstruation, and prolonged menstrual bleeding. This is because normally when menstruation occurs, the uterine lining sheds and blood drains out of the uterus. But with adenomyosis, the uterine lining, or endometrial cells, that are trapped within uterine musculature, bleed but cannot drain out. So the uterus gets bigger and bigger and more and more boggy and enlarged and painful.

Usually the only solution to the misery and pain that adenomyosis can cause is considered to be hysterectomy, that is, removal of the uterus.


Adenomyosis Technical Videos

Osada Procedure for Massive Adenomyosis: Preserving the Uterus.

Osada Procedure for Massive Adenomyosis: Preserving the Uterus.

Post-Op interview with 30 year old adenomyosis patient cured by Osada surgical procedure in St. Louis.

Post-Op interview with 30 year old adenomyosis patient cured by Osada surgical procedure in St. Louis.

Print/Web News Coverage

Read article from Reproductive BioMedicine Online

Surgical procedure to conserve the uterus for future pregnancy in patients suffering from massive adenomyosis. Reproductive BioMedicine Online, 2010.

However many women with adenomyosis do not want to lose their uterus, and wish to be able to have children. For women who wish to become pregnant and have children, this is an awful decision to make. Yet unlike uterine myomas, or fibroids, which can easily be "shelled out" of the uterus because there is a clear line of demarcation between tumor and true uterine musculature, with adenomyosis, there is no such line of demarcation. The uterine muscle is completely infiltrated with endometriosis tissue, diffusely and throughout, and there is not even a clear demarcation of uterine lining.

But a procedure pioneered in Japan by Dr. Hisaeo Osada has solved this problem. The video on the the right shows how this operation is performed, and the scientific paper on the right describes the technique. The idea is to first prevent the massive bleeding this operation would cause by putting a temporary tourniquet around the uterus, and then to open the uterus boldly all the way down to the endometrial lining. Then the non-demarcated adenomyotic tissue is excised leaving a centimeter on the endometrial side and a centimeter on the serosal (outer) side of the uterus. Then the remaining muscle of this debulked adenomyotic uterus musculature is closed with many layers of sutures, all non-overlappying flaps, to prevent the risk of rupture.

The results are immediate and dramatic. There is almost instant relief of pelvic pain, and miserable menstrual periods, and normal periods resume with minimal pain. Furthermore, the patient is now able to get pregnant normally. She will need a C-section, but that is a small price to pay for preserving her uterus, allowing full term pregnancy, and alleviating her painful and miserable symptoms.

See also: