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Dr. Naomi Whittaker shares critical distinctions between diffuse and focal adenomyosis and their impact on fertility. She highlights how adenomyosis is often over-diagnosed on ultrasound while explaining that diffuse adenomyosis rarely affects fertility, though focal adenomyomas require surgical intervention by fertility-friendly specialists.
• Diffuse adenomyosis is more common in women who have had children and typically doesn’t impact fertility
• Adenomyosis is frequently over-diagnosed on ultrasound as technology improves
• Finding adenomyosis on imaging doesn’t necessarily mean it’s clinically significant
• Focal adenomyosis (adenomyomas) can cause infertility but are surgically treatable
• Surgeon choice is critical for fertility preservation
• Concerning cases exist where fallopian tubes were removed without patient consent
• Important to choose fertility-friendly surgeons who handle tissue delicately
Send your questions by using the link in the top of the description of this podcast episode, by emailing contact@endobattery.com, or by visiting the endobattery.com contact page.
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Welcome to EndoBattery's Quick Connect
Speaker 1
0:00
Life
moves
fast
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answers
to
your
biggest
questions
.
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I'm
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alana
,
and
it's
time
to
connect
.
Introducing Dr. Naomi Whitaker
Speaker 1
0:50
I'm
joined
at
the
table
today
by
Dr
Naomi
Whittaker
,
who
is
the
founder
of
RRM
Academy
and
is
an
OBGYN
fertility
surgeon
focused
on
women's
restorative
reproductive
medicine
,
compassionate
healthcare
and
education
.
Dr
Whitaker
is
a
board-certified
OBGYN
,
anda
fellowship-trained
surgeon
who
specializes
in
the
Creighton
Model
Fertility
Care
System
and
Napro
Technology
,
which
works
cooperatively
with
women's
body
to
treat
the
underlying
cause
of
gynecologic
issues
and
infertility
,
such
as
endometriosis
and
PCOS
.
Dr
Whitaker
helps
women
improve
their
gynecologic
health
and
avoid
or
achieve
pregnancy
in
accordance
with
their
natural
fertility
,
using
the
latest
research
,
medicine
and
surgery
.
Understanding Adenomyosis Types
Speaker 1
1:28
Let's
get
started
,
as
a
lot
of
us
that
are
struggling
with
fertility
not
only
have
endometriosis
,
but
have
adenomyosis
as
well
.
Is
that
something
that
you
kind
of
deal
with
on
a
daily
basis
as
part
of
helping
those
achieve
success
in
fertility
?
Speaker 2
1:44
Absolutely
.
So
I
had
to
really
do
my
own
research
on
adenomyosis
because
there's
really
not
good
information
out
there
.
So
there's
technically
two
different
types
of
adenomyosis
there's
diffuse
and
there's
focal
.
So
diffuse
is
more
common
in
women
who
have
had
children
and
does
not
cause
infertility
but
can
cause
the
symptoms
like
fullness
,
heavy
bleeding
.
But
the
good
thing
Adenomyomas and Fertility Impact
Speaker 2
2:10
is
that
shouldn't
really
affect
fertility
.
Speaker 2
2:12
It's
very
often
visualized
on
ultrasound
.
In
an
article
that
I
read
analyzing
many
,
many
studies
and
summarizing
the
findings
,
it
compared
it
to
the
boy
who
cried
wolf
.
So
adenomyosis
is
over
called
on
ultrasound
because
obviously
we
know
endometriosis
is
missed
more
often
than
not
by
ultrasound
and
MRI
.
But
they
might
see
some
junctional
changes
or
whatever
the
ultrasound
findings
are
in
a
large
uterus
.
So
oh
,
it
must
be
that
right
.
Just
because
you
find
it
doesn't
mean
it's
clinically
significant
.
And
now
that
our
ultrasound
technology
is
more
clear
than
it
used
to
be
,
we're
finding
it
more
.
And
now
we're
over
calling
it
based
on
what
I've
been
able
to
find
and
what
I
see
clinically
.
Speaker 2
2:55
I
see
it
frequently
and
I
don't
see
other
signs
of
issues
.
If
it's
just
that
,
for
example
and
I
don't
consider
that
in
my
other
than
management
of
symptoms
,
I
don't
consider
that
as
a
barrier
to
conceiving
.
Now
it's
very
different
.
Someone
messaged
me
today
they
have
a
seven
centimeter
adenomyoma
.
Now
that's
very
different
.
That's
evidence
of
focal
adenomyosis
,
so
a
big
nodule
or
area
of
endometriosis
growing
into
the
muscle
of
the
uterus
,
and
so
those
do
cause
infertility
.
But
the
good
thing
is
those
are
resectable
.
You
just
treat
it
very
similarly
to
endometriosis
and
it's
definitely
trickier
surgically
.
Speaker 1
3:38
But
and
from
my
understanding
and
maybe
I'm
wrong
on
this
but
doing
those
does
increase
risk
,
sometimes
with
fertility
,
depending
on
who
you
see
.
Like
you
wouldn't
want
to
see
,
just
anyone
to
see
,
no
matter
what
.
Speaker 2
3:51
Right
Period
If
you
are
interested
in
fertility
,
and
I
think
that's
something
I
really
want
to
bring
into
light
,
is
that
who
your
surgeon
is
matters
Surgeon Choice Matters for Fertility
Speaker 2
4:00
more
than
anything
.
Right
Because
?
Because
not
only
finding
it
all
,
but
tissue
handling
,
being
very
delicate
with
tissue
I
,
the
fallopian
tubes
you
don't
want
to
do
that
with
these
very
strong
instruments
.
Obviously
you
don't
want
to
take
out
fallopian
tubes
without
patient
consent
,
which
obviously
happens
a
lot
.
I'm
sure
you've
gotten
those
messages
,
like
I
have
.
I
went
under
anesthesia
.
I
woke
up
without
a
fallopian
tube
.
I've
seen
it
on
patients
who
go
to
surgeons
.
They
go
there
for
fertility
.
The
tube
is
taken
out
because
they
thought
it
was
endometriosis
.
Pathology
was
negative
for
endometriosis
on
the
tube
.
They
took
out
the
whole
tube
.
So
surgeon
choice
matters
for
someone
who's
fertility
friendly
,
who
really
respects
that
,
and
so
there's
a
lot
to
it
that's
touching
the
surface
of
Episode Wrap-Up and Contact Info
Speaker 2
4:46
it
.
Speaker 1
4:46
That's
a
wrap
for
this
Quick
Connect
.
I
hope
today's
insights
helped
you
move
forward
with
more
clarity
and
confidence
.
Do
you
have
more
questions
?
Keep
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.
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endobatterycom
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Until
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