247 Materials & Methods Study design & Setting This single-centre retrospective case-control study was conducted at the Catharina Hospital in Eindhoven, the Netherlands, a regional referral centre for fertility and endometriosis treatment. Patients were included between the years of 2007 and 2020. This study was ethically approved by the local institutional review board and the regional Medical Ethical Committee with study number nWMO-2020.005/W20.045, in March 2020. Eligibility criteria: IVF/ICSI Patients between the ages of 18 and 42 years, undergoing their first, fresh embryo transfer in our centre between 2008-2020 were eligible. Study Population IVF/ICSI patients that received an MRI at our hospital (according to local MRI protocol, see appendix 10A) on suspicion of adenomyosis and/or endometriosis were chosen as our study group. In order to confirm the initial diagnosis of adenomyosis and/or endometriosis of the MRI’s that were conducted, a reassessment was made of these MRI’s by pelvic radiologists and a study investigator (CR). The diagnosis of adenomyosis on MRI was made based on one of three criteria: (I) JZ thickness ≥ 12 mm on T2 either focally or diffusely, (II) the presence of high signal intensity foci (HSI) in the myometrium on T1 and/or T2 concordant with an adenomyotic cyst, (III) JZ/myometrium ratio of > 40% on T2. The diagnosis for endometriosis was based on the presence of one of the following criteria; (I) hyperintense (multiple) ovarian cysts on T1 and hypointense intensity on T2, (II) endometriosis plaques and (III) deep infiltrating endometriosis. Patient medical files were then assessed in order to identify which of these patients had undergone IVF/ICSI treatment and received their first fresh embryo transfer (ET) in our fertility department. Patients were included regardless of the timing of the MRI in relation to IVF/ICSI treatment. Control Population: The control group included women undergoing IVF/ICSI treatment due to a male factor only, with normal uteri on TVUS, or MRI where available. We chose only to include controls on the basis of normal uterus on imaging and
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