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Abnormal Uterine Bleeding in Women with Infertility

  • Reproductive Endocrinology and Infertility (REI) (R Anchan, Section Editor)
  • Published:
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Abstract

Purpose of Review

Abnormal uterine bleeding (AUB) is a common gynecologic complaint of reproductive-age women that necessitates careful evaluation due to potential underlying structural and systemic abnormalities. The majority of studies on AUB and infertility examine these topics separately, despite emerging evidence that many etiologies of AUB influence fertility. This review aims to provide an updated perspective on the diagnosis and management of AUB in the context of the infertility evaluation.

Recent Findings

The FIGO PALM-COEIN classification of AUB allows for the precise identification of systemic and structural causes to guide management. Pelvic ultrasound continues to be an accessible first-line imaging technique with high sensitivity for detecting structural etiologies of abnormal bleeding, particularly when used with color Doppler or 3D imaging. Notably, recent studies suggest that many of the endometrial pathologies that lead to AUB can also negatively impact endometrial receptivity, perhaps contributing to infertility in some women.

Summary

While the impact of systemic causes of AUB, such as ovulatory dysfunction, on infertility is widely recognized, the extents to which endometrial disorders and discrete structural lesions affect fertility are not entirely understood. More research is needed to assess the impact of structural abnormalities and their treatment on subsequent fertility outcomes in women with AUB.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Caitlin R. Sacha

  2. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Massachusetts General Hospital Fertility Center and Harvard Medical School, Boston, MA, USA

    Irene Souter

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Correspondence to Caitlin R. Sacha.

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Sacha, C.R., Souter, I. Abnormal Uterine Bleeding in Women with Infertility. Curr Obstet Gynecol Rep 6, 42–50 (2017). https://doi.org/10.1007/s13669-017-0188-0

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