{"paper_id":"410a6ba5-8b42-4a98-b9db-ec7533d8c909","body_text":"Abstract\nBackground\nAdenomyosis affects the outcomes of spontaneous fertility and assisted reproductive technology. The single blastocyst embryo transfer (SBT) policy is an effective strategy known to minimize the risk of multiple pregnancy for non-adenomyosis women. However, little is known about its applicability to women with adenomyosis. The purpose of this study is to compare pregnancy outcomes between SBT, double-blastocyst embryo transfer (DBT), single-cleavage-stage embryo transfer (SET) and double-cleavage-stage embryo transfer (DET) in the frozen–thawed embryo transfer cycles among adenomyosis patients.\nMethods\nThis retrospective study was conducted in all frozen–thawed autologous embryo transfer cycles. 393 frozen–thawed embryo transfer cycles performed in adenomyosis patients were enrolled. The major clinical outcomes were implantation rate (IR), clinical pregnancy rate (CPR), miscarriage rate (MR), multiple pregnancy rate (MPR) and live birth rate (LBR).\nResults\nThe SBT and DBT groups achieved higher IR (P < 0.001), CPR (P = 0.017), LBR (P = 0.040) and lower MR (P = 0.020) than the SET and DET groups. But the SBT and DBT groups achieved similar CPR and LBR. The SBT and SET groups achieved lower MPR (P < 0.001) than the DBT and DET groups. The average birth weight (BW) of SBT groups was higher than the DBT and DET groups (P = 0.016). When compared with SBT group, low-birth-weight infants were significantly higher with DBT and DET.\nConclusions\nWhen performing frozen–thawed embryo transfer cycles among adenomyosis patients, the SBT group has similar IR, CPR, MR, LBR but lower MPR compared to the DBT group. Therefore, SBT might be offered as standard practice.\nSimilar content being viewed by others\nData availability\nThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\nAbbreviations\n- AMH:\n-\nAnti-Mullerian hormone\n- ASRM:\n-\nThe American Society for Reproductive Medicine\n- BMI:\n-\nBody mass index\n- BPR:\n-\nBiochemical pregnancy rate\n- BW:\n-\nBirth weight\n- COH:\n-\nControlled ovarian hyperstimulation\n- COS:\n-\nControlled ovarian stimulation\n- CPR:\n-\nClinical pregnancy rate\n- DBT:\n-\nDouble-blastocyst embryo transfer\n- DET:\n-\nDouble-cleavage-stage embryo transfer\n- eNOS:\n-\nEndothelial nitric oxide synthase\n- GnRH-a:\n-\nGonadotropin-releasing hormone agonist\n- hCG:\n-\nHuman chorionic gonadotropin\n- HRT:\n-\nHormone replacement treatment\n- ICIS:\n-\nIntracytoplasmic sperm injection\n- IR:\n-\nImplantation rate\n- IVF:\n-\nIn vitro fertilization\n- LBR:\n-\nLive birth rate\n- MPR:\n-\nMultiple pregnancy rate\n- MR:\n-\nMiscarriage rate\n- PBR:\n-\nPreterm birth rate\n- SBT:\n-\nSingle-blastocyst embryo transfer\n- SET:\n-\nSingle-cleavage-stage embryo transfer\n- VEGF:\n-\nVascular endothelial growth factor\nReferences\nMaheshwari A, Gurunath S, Fatima F, Bhattacharya S (2012) Adenomyosis and subfertility: a systematic review of prevalence, diagnosis, treatment and fertility outcomes. 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Reprod Biomed Online 38(6):892–900. https://doi.org/10.1016/j.rbmo.2018.12.034\nAcknowledgements\nNot applicable.\nFunding\nThis work was supported by the Science and Technology Program of Guangdong Province (2014A020213002) and the Free Application Project of Guangdong Natural Science Foundation (2015A030313131).\nAuthor information\nAuthors and Affiliations\nContributions\nJG and ZZ designed the study. ML and JH were responsible for the data collection and checking. JG performed the data analysis and manuscript drafting. JP, MW and XL dealt with data visualization. HZ supervised the project administration.\nCorresponding author\nEthics declarations\nConflict of interest statement\nThe authors have no conflicts of interest to declare.\nEthics approval\nThis study was approved by the ethics committee of the Sixth Affiliated Hospital of Sun Yat-sen University.\nInformed consent\nThe requirement of informed consent was waived by the ethics committee because of the retrospective nature of the study.\nAdditional information\nPublisher's Note\nSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.\nRights and permissions\nAbout this article\nCite this article\nGuo, J., Zeng, Z., Li, M. et al. Clinical outcomes after single-versus double-embryo transfers in women with adenomyosis: a retrospective study. Arch Gynecol Obstet 304, 263–270 (2021). https://doi.org/10.1007/s00404-020-05924-5\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-020-05924-5","source_license":"CC0","license_restricted":false}