You've had the tests. You've tracked your cycles. You've done everything right. But no one mentioned adenomyosis. New research shows nearly 1 in 5 infertile women have it—and most don't know. Here's what you need to know.
You've been on the fertility journey for months. Maybe years. You've had the blood tests, the ultrasounds, the consultations. You've tracked your basal body temperature, your cervical mucus, your ovulation windows. You've done everything the doctors and the apps and the forums have told you to do. And still, no pregnancy. Still, no answers.
But here's a question you've probably never been asked: Has anyone checked your uterine muscle for adenomyosis?
New research published just this month suggests they should be.
April is Adenomyosis Awareness Month, and a groundbreaking study released on April 14, 2026, has revealed something that should change fertility care forever. Researchers found that 17.13% of infertile women had adenomyosis detected on routine ultrasound screening—with over half classified as severe. Even more striking, women with secondary infertility (who had conceived before but couldn't again) had nearly double the prevalence at 28.85% .
This is not a niche finding. This is 1 in 5 women. And yet, routine screening for adenomyosis is not standard practice in most fertility clinics. Why? Because for decades, we were told adenomyosis was a condition of older women, diagnosed only after hysterectomy. That thinking is now dangerously outdated.
This post is for the women who have been searching for answers. For those who've had unexplained infertility or recurrent implantation failure. For anyone who wants to understand why their fertility treatment hasn't worked—and what to ask their doctor next.
What the April 2026 Study Revealed
The study, published in the Journal of Obstetrics and Gynaecology Research, screened infertile women using routine ultrasound—looking specifically for signs of adenomyosis in the uterine muscle wall. The findings were striking:
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17.13% of all infertile women had adenomyosis detected
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Over half of those cases (8.81%) were classified as severe
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Women with secondary infertility (previous pregnancy but unable to conceive again) had a 28.85% prevalence
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Women with primary infertility had a 13.11% prevalence
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The odds of having adenomyosis were significantly higher in women with sonographically diagnosed polycystic ovaries and those with longer infertility duration
What does this mean? It means that for a significant subset of women, adenomyosis may be the missing piece of the infertility puzzle. And it means that routine screening for adenomyosis should be part of every fertility workup—especially for women with secondary infertility or PCOS.
Why Adenomyosis Affects Fertility
Adenomyosis isn't just about pain and heavy bleeding. It can directly impact fertility through several mechanisms:
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Impaired implantation: The inflamed, enlarged uterine muscle can create a hostile environment for an embryo trying to implant
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Altered uterine contractility: The abnormal muscle structure can affect sperm transport and embryo placement
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Chronic inflammation: The ongoing inflammatory state associated with adenomyosis can interfere with embryo development
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Reduced endometrial receptivity: The lining of the uterus may not be as receptive to implantation
For women undergoing IVF, adenomyosis has been linked to lower implantation rates, higher miscarriage rates, and reduced live birth rates. Yet many women go through multiple cycles without anyone ever checking for it.
I think about Rachael, who went through three rounds of IVF. Each time, the embryos looked beautiful. Each time, the transfer went perfectly. And each time, nothing. Her doctor called it "unexplained infertility." She was left with no answers and a mountain of grief.
Years later, she was diagnosed with adenomyosis during a workup for something else entirely. "I was angry," she told me. "Why didn't anyone check? I went through three cycles. Three. All that money, all that hope, all that heartbreak. And the answer was there the whole time, hiding in my uterine muscle."
Rachael's story is not unique. And it's why this new research matters so much.
What to Ask Your Doctor
If you're on a fertility journey—or if you've experienced recurrent pregnancy loss or unexplained infertility—here's what you need to ask:
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"Has my uterus been evaluated for adenomyosis?" A standard transvaginal ultrasound can often detect signs, though MRI is more sensitive. The MUSA criteria (Morphological Uterus Sonographic Assessment) are now established for diagnosis.
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"Could adenomyosis be affecting my implantation?" If you've had recurrent implantation failure or unexplained infertility, this is a crucial question.
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"Should we consider treatment before another transfer?" For some women, treating adenomyosis (with hormonal medications, HIFU, or other uterine-preserving options) before a transfer may improve outcomes.
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"Is my clinic screening for adenomyosis routinely?" If not, ask why. This new research suggests they should be.
The Adenomyosis-Fertility Connection: What We Still Don't Know
The April 2026 study is a major step forward, but researchers acknowledge limitations. The study had a relatively small sample size, and the prevalence they found (17.13%) is higher than some previous estimates. More research is needed to understand:
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Whether treating adenomyosis improves fertility outcomes
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Which treatments are most effective for fertility preservation
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How adenomyosis interacts with other conditions like endometriosis or PCOS
But here's what we do know: you can't treat what you don't diagnose. And for too long, adenomyosis has been invisible in fertility care.
The Aprés Connection: Supporting Your Body Through Treatment
While you're navigating the fertility journey—whether that's IVF, hormonal treatments, or other interventions—your body is going through a lot. One of the most common fertility treatments is vaginal progesterone, used to support the uterine lining during the luteal phase and after embryo transfer.
The reality? These pessaries leave behind residue. Messy, uncomfortable, undignified residue that you have to manage the next morning. For women already feeling emotionally fragile from the fertility rollercoaster, this daily indignity adds insult to injury.
Aprés offers a simple solution. After your overnight progesterone, a quick insertion and rotation of the soft, medical-grade sponge absorbs the residue—leaving you feeling clean, comfortable, and in control. No fishing. No shame. Just dignity.
It's a small thing. But on the fertility journey, small things matter.
Your Top Questions Answered!
1. "I've had infertility testing. Would adenomyosis have shown up?"
Not necessarily. Standard fertility testing often focuses on ovarian reserve, tubal patency, and semen analysis. Adenomyosis requires specific evaluation of the uterine muscle—usually via ultrasound with someone trained in MUSA criteria, or via MRI. If no one was looking for it, it may have been missed.
2. "Can I have adenomyosis without symptoms?"
Yes. The April 2026 study found that many women with adenomyosis on ultrasound had no classic symptoms like heavy bleeding or severe pain. This is why routine screening is so important—you can have it and not know.
3. "Does treating adenomyosis improve fertility?"
Research is ongoing, but early evidence suggests that treating adenomyosis may improve implantation and pregnancy rates. Options include hormonal suppression (like GnRH agonists), HIFU ablation, or in some cases, surgical resection. Talk to a specialist about what might be right for you.
4. "Is Aprés safe to use during fertility treatment?"
Yes. Aprés is a soft, medical-grade sponge designed for gentle absorption. By morning, your progesterone has been absorbed, and the residue is simply the carrier base. Aprés removes that residue without affecting treatment efficacy. As always, check with your fertility specialist if you have specific concerns.
Your 4-Step Guide to Advocating for Yourself
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Ask the Question: At your next fertility appointment, ask: "Has anyone evaluated my uterus for adenomyosis?" If the answer is no, ask for a referral for an ultrasound with someone trained in MUSA criteria.
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Know Your Risk: If you have secondary infertility (you've conceived before but can't again), PCOS, or a long infertility duration, your risk is higher. Advocate for screening.
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Manage the Daily Realities: While you're navigating the big picture, don't forget the small things. Keep Aprés on your nightstand for the morning after your progesterone. It's one less indignity to manage.
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Find Your Community: Adenomyosis can feel isolating, but you're not alone. Online support groups and advocacy organisations offer connection, information, and validation.
Key Takeaways:
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New April 2026 research found that 17.13% of infertile women have adenomyosis on ultrasound screening.
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Women with secondary infertility had nearly double the prevalence at 28.85% .
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Over half of detected cases were classified as severe (8.81%).
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Adenomyosis can impair fertility through impaired implantation, altered contractility, and chronic inflammation.
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Routine screening for adenomyosis is not yet standard in most fertility clinics—but it should be.
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Standard fertility testing often misses adenomyosis because it requires specific uterine muscle evaluation.
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You can have adenomyosis without classic symptoms like heavy bleeding or pain.
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For women using vaginal progesterone in fertility treatment, Aprés offers dignified residue management.
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This Adenomyosis Awareness Month, ask your doctor the question.
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You deserve answers. And you deserve tools that support your body through the journey.
Are you on a fertility journey? Have you asked about adenomyosis? New research shows 1 in 5 infertile women have it—but most don't know. Advocate for yourself, ask the question, and discover how tools like Aprés can support your body through treatment. For more honest conversations about women's health, subscribe HERE
