Received June 17, 2023
Accepted December 23, 2023

Objective: Adenomyosis associated with subfertility is a situation of a dilemma for the treating clinician as the treatment is highly controversial and there remains an overall lack of consensus regarding the value of con-servative surgery with or without medical management to improve reproductive outcomes. Hence we proposed this classification based on mapping of the size of adenomyoma, its location, distance from the endometrial cavity, and any associated endometriosis by studying 100 women with adenomyosis undergoing IVF. Methods: We did a prospective study over 2 years in 100 women with adenomyosis who underwent IVF. They were classified into 4 categories based on our management-based proposed classification and the preg-nancy outcomes were studied in each group. Results: According to our classification, 56% of women belonged to grade 1, 24 % to grade 2, 8% to grade 3, and 12 % to Grade 4 Adenomyosis. The Pregnancy rates were 71 % in Grade 1, 66 % with Medical manage-ment, and 33 % with surgical management in Grade 2, Grade 3 were offered surrogacy, and 66 % in Grade 4 Adenomyosis. Conclusion: Our classification is simple and allows cost-effective management based on the location and ex-tent of the disease with the help of ultrasonography.