MYOMETRIAL ELASTOGRAPHY AS A POTENTIAL MARKER OF PROGESTIN RESISTANCE IN ADENOMYOSIS

Some women with adenomyosis respond poorly to progestins, and conventional grey-scale ultrasound cannot reliably identify them before treatment. This thesis reviews studies published in 2022–2025 on ultrasound elastography of adenomyotic lesions. Lesion stiffness is higher than that of normal myometrium, is accompanied by higher expression of fibrosis markers and correlates with the severity of dysmenorrhoea. In women treated with dienogest for six months, higher lesion stiffness was associated with symptom relapse after treatment was stopped. No study has yet reported a stiffness threshold that predicts insufficient response during treatment. Elastography therefore deserves evaluation as a component of prognostic models of response to progestin therapy.