{"paper_id":"722bc74c-a310-4cf1-b25d-6a88ffb3e99b","body_text":"Overcoming adenomyosis in in vitro fertilization: a case series\nDOI:\nhttps://doi.org/10.18203/2320-1770.ijrcog20260898Keywords:\nAdenomyosis, In vitro fertilization, GnRH antagonist, Case series, Frozen embryo transfer, Freeze-allAbstract\nAdenomyosis is increasingly diagnosed in infertile women and is associated with adverse in vitro fertilization (IVF) outcomes. Individualizing ovarian stimulation and embryo transfer strategies may improve reproductive outcomes. This retrospective case series includes three women with imaging-confirmed adenomyosis who underwent IVF using a gonadotropin-releasing hormone (GnRH) antagonist protocol with a freeze-all strategy, followed by frozen embryo transfer (FET). Clinical characteristics, stimulation parameters, embryological outcomes, and pregnancy outcomes were evaluated. All patients completed ovarian stimulation with satisfactory oocyte yield and embryo development. Frozen embryo transfer was performed following GnRH agonist down-regulation and hormone replacement therapy. All three patients achieved ongoing clinical pregnancy. Favorable IVF outcomes can be achieved in women with adenomyosis using an antagonist protocol combined with a freeze-all strategy and frozen embryo transfer. Larger prospective studies are required to validate these findings.\nMetrics\nReferences\nGe L, Li Y, Zhou J, Zhao X, Chen X, Wang W, et al. Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis. BMJ Open. 2024;14(7):e077025. DOI: https://doi.org/10.1136/bmjopen-2023-077025\nPados G, Gordts S, Sorrentino F, Nisolle M, Nappi L, Daniilidis A. Adenomyosis and infertility: a literature review. Medicina. 2023;59(9):1551. DOI: https://doi.org/10.3390/medicina59091551\nCozzolino M, Tartaglia S, Pellegrini L, Troiano G, Rizzo G, Petraglia F. The effect of uterine adenomyosis on IVF outcomes: a systematic review and meta-analysis. Reprod Sci. 2022;29(11):3177-93. DOI: https://doi.org/10.1007/s43032-021-00818-6\nWu HM, Tsai TC, Liu SM, Pai AH, Chen LH. The current understanding of molecular mechanisms in adenomyosis-associated infertility and the treatment strategy for assisted reproductive technology. Int J Mol Sci. 2024;25(16):8937. DOI: https://doi.org/10.3390/ijms25168937\nWu Y, Huang J, Zhong G, Lan J, Lin H, Zhang Q. Long-term GnRH agonist pretreatment before frozen embryo transfer improves pregnancy outcomes in women with adenomyosis. Reprod Biomed Online. 2022;44(2):380-8. DOI: https://doi.org/10.1016/j.rbmo.2021.10.014\nZhang W, Han B, Ma C, Qiao J. Effect of GnRH-a pretreatment before frozen-thawed embryo transfer on pregnancy outcome of adenomyosis-associated infertile patients with 56 cm3≤ uterine volume≤ 100 cm3. Ann Transl Med. 2022;10(9):509. DOI: https://doi.org/10.21037/atm-21-6247\nSteinmann M, Anthon C, Schwartz AS, Mackens S, Blockeel C, Kalaitzopoulos DR, et al. GnRH agonist pretreatment prior to frozen embryo transfer in women with adenomyosis: a systematic review and meta-analysis. Reprod BioMed Online. 2025;51(5). DOI: https://doi.org/10.1016/j.rbmo.2025.105075","source_license":"CC0","license_restricted":false}