Administration of Oxytocin Receptor Antagonist during Frozen Embryo Transfer: Potential Improvement in Live Birth Rates for Women with Recurrent Implantation Failure, Adenomyosis, and Myoma

Administration of Oxytocin Receptor Antagonist during Frozen Embryo Transfer: Potential Improvement in Live Birth Rates for Women with Recurrent Implantation Failure, Adenomyosis, and Myoma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Administration of Oxytocin Receptor Antagonist during Frozen Embryo Transfer: Potential Improvement in Live Birth Rates for Women with Recurrent Implantation Failure, Adenomyosis, and Myoma Po-Wen Lin, Chyi-Uei Chern, Chia-Jung Li, Pei-Hsuan Lin, Yu-Chen Chen, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3849849/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The primary objective of this investigation was to assess the potential improvement in pregnancy outcomes among infertile women undergoing in vitro fertilization (IVF) cycles, specifically during frozen embryo transfer (FET), following the administration of an oxytocin receptor antagonist. This study aimed to examine this impact across various subgroups, including individuals experiencing recurrent implantation failure (RIF), adenomyosis, and myoma. Methods This retrospective cohort study involved 431 patients who underwent their initial IVF-FET cycle at our reproductive center between January and December 2021. The study group (n = 162) received an oxytocin receptor antagonist during FET, while the control group (n = 227) underwent FET without this antagonist. A comparative analysis of baseline and cycle characteristics was conducted between the two groups, with additional subgroup analyses. Results There were no significant differences in baseline or cycle characteristics between the study and control groups. Overall, there was no significant difference in live birth rate between the two groups. However, in specific subgroups, the study group demonstrated significantly greater live birth rates than did the control group for patients with RIF (43.9% vs. 26.2%, P = 0.016), adenomyosis (37.7% vs. 22.1%, P = 0.039), or myoma (46.3% vs. 20.4%, P = 0.004). Multivariate analysis indicated a positive association between oxytocin receptor antagonist use and live birth rates in women with RIF (adjusted OR 2.17, 95% CI 1.08–4.35; P = 0.030), adenomyosis (adjusted OR 3.44, 95% CI 1.43–8.28; P = 0.006), and myoma (adjusted OR 3.11, 95% CI 1.23–7.85; P = 0.016). Conclusions While the administration of an oxytocin receptor antagonist during FET did not increase live birth rates in the overall population, it exhibited potential benefits in improving live birth rates in women with RIF, adenomyosis, or myoma. Oxytocin receptor antagonist atosiban frozen embryo transfer recurrent implantation failure adenomyosis myoma in vitro fertilization Figures Figure 1 Introduction Uterine dynamics encompass uterine peristalsis, giving rise to endometrial waves during various phases of the menstrual cycle. During the luteal phase, the uterus assumes a quiescent state conducive to embryo implantation [ 1 ]. Embryo transfer (ET) constitutes the final critical stage of in vitro fertilization (IVF). Research indicates that heightened contraction activity at the time of ET in IVF cycles correlates negatively with successful pregnancies [ 2 , 3 ]. A meta-analysis demonstrated the significant adverse effect of increased contraction frequency (> 3 contractions/minute) on pregnancy rates [ 1 ]. In a prospective cohort study, the nonpregnant group consistently exhibited a greater contraction frequency than the pregnant group [ 4 ]. Therefore, elevated uterine contractions during embryo implantation significantly diminish pregnancy rates, with higher contraction frequencies exacerbating this adverse impact. Oxytocin initiates contractions by binding to oxytocin receptors, primarily through elevating intracellular calcium and prostaglandin levels, resulting in uterine myometrium contractions and eventually leading to labor and delivery [ 5 , 6 ]. Oxytocin receptor antagonists, which mimic oxytocin with stronger receptor affinity, function by reducing prostaglandin production and calcium influx into cells, thereby inhibiting uterine contractions [ 7 , 8 ]. While oxytocin receptor antagonists are commonly used for tocolysis [ 9 , 10 ], their application in treating ET is currently under investigation. Previous studies have indicated that administering oxytocin receptor antagonists during ET improves pregnancy outcomes. A Cochrane Review and a meta-analysis both suggested that intravenous oxytocin receptor antagonist administration improved clinical pregnancy rates in infertile women undergoing IVF-ET [ 11 , 12 ]. However, further research is necessary to assess the impact of these factors on live birth rates. Women with recurrent implantation failure (RIF) reportedly exhibit heightened uterine peristalsis. The administration of oxytocin receptor antagonists during ET has demonstrated benefits in this cohort [ 13 ]. Adenomyosis and myomas are also correlated with increased uterine peristalsis frequencies [ 14 , 15 ]. Our hypothesis posits that the administration of oxytocin receptor antagonists during ET may improve IVF outcomes in women with adenomyosis and myomas. However, there is a paucity of published studies on this subject, and data on live birth rates are lacking. Therefore, this study aimed to investigate the impact of oxytocin receptor antagonist use during frozen embryo transfer (FET) on live birth rates in infertile women, with a specific focus on subgroups, including RIF, adenomyosis, and myomas. Materials and methods Study design and participants This retrospective cohort study was conducted at the Reproductive Medical Center of Kaohsiung Veterans General Hospital from January 2021 to December 2021. Approval for this study was obtained from the Institutional Review Board of Kaohsiung Veterans General Hospital (reference number: KSVGH23-CT5-06). Given its retrospective design, the need for consent was waived by the Institutional Review Board. Patient data were retrieved from electronic medical records and IVF treatment sheets within the study period. The inclusion criterion included patients who underwent their first IVF-FET cycle at our reproductive center, for a total of 431 patients. The exclusion criteria were as follows: (i) ≥ 46 years of age, (ii) underwent preimplantation genetic testing cycles for aneuploidy (PGT-A), (iii) were oocyte recipients, (iv) had primary ovarian insufficiency, (v) had a husband who underwent testicular sperm extraction, (vi) had congenital uterine anomalies or severe intrauterine adhesions, (vii) had cancer, and (viii) were lost to follow-up. Consequently, 389 patients were enrolled and divided into a study group and a control group. An oxytocin receptor antagonist was administered during the FET procedure in the study group but not in the control group. The decision to administer the oxytocin receptor antagonist depended on the clinical judgment of the physician. The study flow chart is depicted in Fig. 1 . IVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection; FET, frozen embryo transfer; PGT-A, preimplantation genetic testing for aneuploidy; POI, primary ovarian insufficiency; TESE, testicular sperm extraction; IUA, intrauterine adhesion Treatment protocol Both the natural cycle and artificial cycle were used for endometrial preparation. In the natural cycle, patients were instructed to use ovulation kits starting from day 10 of their menstrual cycle. Once a positive result was obtained, consecutive blood tests for LH, progesterone, and estrogen were conducted to predict the ovulation day. In the artificial cycle, endometrial preparation involved daily oral estradiol (Ediol, 8 mg; Synmosa Biopharma Corporation, Hsinchu County, Taiwan) and estradiol gel (Oestrogel gel; Besins, Drogenbos, Belgium), which were initiated before cycle day 5. In the natural cycle, luteal phase support, including intravaginal gel (Crinone 8% gel, Merck Serono, Hertfordshire, UK) and oral dydrogesterone (Duphaston 40 mg, Abbott, Olst, the Netherlands), commenced once the ovulation day was confirmed. In the artificial cycle, supplementation began when the endometrial thickness reached at least 8 mm. Following assisted hatching via laser zona drilling, the frozen-thawed embryos were transferred under transabdominal sonographic guidance. In the study group, atosiban (tractocile, 7.5 mg/ml; Ferring, Kiel, Germany) was administered as an intravenous bolus of 6.75 mg before EF, followed by a continuous infusion of the remaining dose (30.75 mg) in 100 mL of normal saline at a rate of 15.4 mg/h. The total administered dose was 37.5 mg, and the total administered duration was 2 hours. Progesterone supplementation was prescribed in both groups until 8–10 gestational weeks after pregnancy was confirmed. Outcome measures The primary outcome measure was the live birth rate, defined as the delivery of a viable fetus beyond 24 weeks of gestation. The secondary outcomes included the clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate. The clinical pregnancy rate was defined as the detection of a fetal heartbeat at 6–7 weeks of gestation. The ongoing pregnancy rate referred to pregnancies beyond 12 weeks of gestation, while the miscarriage rate denoted pregnancy loss before 24 weeks of gestation. Statistical analysis The Kolmogorov–Smirnov test was used to assess the normality of the distribution of continuous variables. The independent t test was used to evaluate quantitative variables. Categorical variables were examined using the chi-square test. Multivariate logistic regression was employed to identify independent effects in subgroups, with adjustments for various covariates, such as age, BMI, infertility duration, type of infertility, AMH level, endometrial thickness, FET protocol, and day of ET. The results are presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 20.0 (Chicago, IL, USA), with a significance level set at P < 0.05. Results As illustrated in Fig. 1 , among 998 IVF/ICSI cycles, 431 patients underwent their first IVF-FET cycle at our reproductive center. After excluding 42 patients, the remaining 389 patients were divided into a study group (n = 162) and a control group (n = 227). Table 1 presents a comparison of the baseline characteristics of the study population. No significant differences were observed in terms of age, infertility duration, previous IVF attempts, type of infertility, cause of infertility, or AMH levels between the two groups. However, a greater BMI was noted in the control group than in the study group. Table 1 Baseline characteristics of patients who did or did not receive atosiban during frozen embryo transfer Parameters Atosiban (n = 162) Control (n = 227) p value Age (years) 38.2 ± 4.4 38.2 ± 4.5 0.923 Body mass index (kg/m 2 ) 23.0 ± 3.4 24.1 ± 4.5 0.009 Infertility duration (years) 4.4 ± 3.3 4.8 ± 3.0 0.219 Previous IVF attempts(%) 0.414 0–1 38.3%(62/162) 32.6%(74/227) 2 21.0%(34/162) 20.3%(46/227) ≧ 3 40.7%(66/162) 47.1%(107/227) Types of infertility (%) 0.725 Primary infertility 47.5%(77/162) 49.3%(112/227) Secondary infertility 52.5%(85/162) 50.7%(115/227) Causes of infertility (%) 0.218 Tubal factor 4.3%(7/162) 7.0%(16/227) Male factor 3.1%(5/162) 4.8%(11/227) POR 8.6%(14/162) 6.2%(14/227) PCOS 13.0%(21/162) 8.4%(19/227) Endometriosis 10.5%(17/162) 6.6%(15/227) Uterine factor 9.9%(16/162) 13.2%(30/227) Unexplained 13.6%(22/162) 9.7%(22/227) Multiple 37.0%(60/162) 44.1%(100/227) Anti-Müllerian hormone(ng/mL) 3.16 ± 2.84 3.15 ± 3.21 0.990 The data are presented as the mean ± standard deviation (SD) and %. IVF, in vitro fertilization; POR, poor ovarian responder; PCOS, polycystic ovarian syndrome The cycle characteristics and pregnancy outcomes of the study population are presented in Table 2 . No significant differences were observed regarding endometrial thickness, FET protocol, day of ET, style used during ET, or percentage of at least one top-quality embryo transferred between the two groups. The biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, live birth rate, and miscarriage rate were similar between the two groups. Table 2 Cycle characteristics of patients with or without atosiban administration during frozen embryo transfer Parameters Atosiban (n = 162) Control (n = 227) p value Endometrial thickness (mm) 10.9 ± 2.7 10.6 ± 2.6 0.401 Protocol 0.567 Natural cycle 20.4% (33/162) 18.1% (41/227) HRT cycle 79.6% (129/162) 81.9% (186/227) ET day (%) 0.118 Day 3 ET 55.6% (90/162) 63.4% (144/227) Day 5 ET 44.4% (72/162) 36.6% (83/227) Style use (%) 13.6% (22/162) 8.8% (20/162) 0.135 At least one top-quality embryos transferred (%) 79.0% (128/162) 78.9% (179/227) 0.970 Biochemical pregnancy rate (%) 56.2% (91/162) 49.8% (113/227) 0.213 Clinical pregnancy rate (%) 43.8% (71/162) 39.6% (90/227) 0.409 Ongoing pregnancy rate (%) 40.7% (66/162) 35.7% (81/227) 0.310 Live birth rate (%) 40.7% (66/162) 33.9% (77/227) 0.169 Miscarriage rate (%) 7.0% (5/71) 16.7% (15/90) 0.066 The data are presented as the mean ± standard deviation (SD) and %. HRT, hormone replacement therapy; ET, embryo transfer The study population was subsequently stratified into three subgroups: patients with RIF, patients with adenomyosis, and patients with myoma. Compared to those in the control group, the study group exhibited significantly greater ongoing pregnancy rates (RIF, 43.9% vs. 28%, P = 0.032; adenomyosis, 37.7% vs. 22.1%, P = 0.039; myoma, 46.3% vs. 20.4%, P = 0.004) and live birth rates (RIF, 43.9% vs. 26.2%, P = 0.016; adenomyosis, 37.7% vs. 22.1%, P = 0.039; myoma, 46.3% vs. 20.4%, P = 0.004). A lower miscarriage rate was observed in the study group within the RIF subgroup (3.3% vs. 20%, P = 0.041) (Table 3 ). Table 3 Basic and cycle characteristics of patients with RIF, adenomyosis or myoma who underwent atosiban administration or not during frozen embryo transfer Parameter Recurrent implantation failure Adenomyosis Myoma Atosiban Control p value Atosiban Control p value Atosiban Control p value Patients, n 66 107 69 77 54 54 Age (years) 40.1 ± 3.6 40.1 ± 4.2 0.969 38.9 ± 4.1 39.1 ± 4.4 0.760 39.5 ± 3.6 40.3 ± 4.6 0.332 Body mass index (kg/m2) 22.8 ± 3.1 24.2 ± 4.6 0.013 23.1 ± 3.7 24.6 ± 4.7 0.028 23.0 ± 3.3 23.3 ± 3.6 0.747 Infertility duration (years) 5.7 ± 3.7 5.6 ± 3.2 0.855 4.5 ± 3.5 4.8 ± 3.1 0.674 4.1 ± 3.2 5.1 ± 3.3 0.147 Types of infertility (%) 0.293 0.706 0.176 Primary infertility 45.5% (30/66) 37.4% (60/107) 44.9% (31/69) 48.1% (37/77) 48.1% (26/54) 61.1% (33/54) Secondary infertility 54.5% (36/66) 62.6% (67/107) 55.1% (38/69) 51.9% (40/77) 51.9% (28/54) 38.9% (21/54) Anti-Müllerian hormone (ng/mL) 2.98 ± 2.64 2.51 ± 2.45 0.233 2.78 ± 2.69 2.50 ± 2.77 0.535 2.84 ± 2.43 2.31 ± 2.95 0.314 Endometrial thickness (mm) 10.6 ± 3.3 10.3 ± 2.6 0.562 10.8 ± 2.4 10.1 ± 2.5 0.087 10.3 ± 2.3 10.4 ± 2.4 0.958 Protocol 0.952 0.571 0.653 Natural cycle 25.8% (17/66) 26.2% (28/107) 23.2% (16/69) 27.3% (21/77) 25.9% (14/54) 22.2% (12/54) HRT cycle 74.2% (49/66) 73.8% (79/107) 76.8% (53/69) 72.7% (56/77) 74.1% (40/54) 77.8% (42/54) Rate of ET day (%) 0.157 0.743 0.046 Day 3 ET 60.6% (40/66) 71.0% (76/107) 62.3% (43/69) 64.9% (50/77) 53.7% (29/54) 72.2% (39/54) Day 5 ET 39.4% (26/66) 29.0% (31/107) 37.7% (26/69) 35.1% (27/77) 46.3% (25/54) 27.8% (15/54) Rate of at least one top-quality embryos transferred (%) 80.3% (53/66) 75.7% (81/107) 0.482 75.4% (52/69) 72.7% (56/77) 0.717 77.8% (42/54) 72.2% (39/54) 0.505 Biochemical pregnancy rate (%) 56.1% (37/66) 45.8% (49/107) 0.190 60.9% (42/69) 39.0% (30/77) 0.008 63.0% (34/54) 35.2% (19/54) 0.004 Clinical pregnancy rate (%) 45.5% (30/66) 32.7% (35/107) 0.093 42.0% (29/69) 23.4% (18/77) 0.016 51.9% (28/54) 22.2% (12/54) 0.001 Ongoing pregnancy rate (%) 43.9% (29/66) 28.0% (30/107) 0.032 37.7% (26/69) 22.1% (17/77) 0.039 46.3% (25/54) 20.4% (11/54) 0.004 Live birth rate (%) 43.9% (29/66) 26.2% (28/107) 0.016 37.7% (26/69) 22.1% (17/77) 0.039 46.3% (25/54) 20.4% (11/54) 0.004 Miscarriage rate (%) 3.3% (1/30) 20.0% (7/35) 0.041 10.3% (3/29) 5.6% (1/18) 0.567 10.7% (3/28) 8.3% (1/12) 0.818 The data are presented as the mean ± standard deviation (SD) and %. RIF, recurrent implantation failure; HRT, hormone replacement therapy; ET, embryo transfer As depicted in Table 4 , a binary logistic regression analysis was conducted to assess the impact of atosiban on live birth rates within the RIF, adenomyosis, and myoma subgroups. Age, BMI, infertility duration, type of infertility, AMH level, endometrial thickness, FET protocol, and day of ET were considered confounding factors in this analysis. Multivariate analysis revealed that the use of atosiban was positively associated with live birth rates in women with RIF (adjusted OR 2.17, 95% CI 1.08–4.35; P = 0.030), adenomyosis (adjusted OR 3.44, 95% CI 1.43– 8.28; P = 0.006), and myoma (adjusted OR 3.11, 95% CI 1.23–7.85; P = 0.016). Table 4 Logistic regression analyses of factors affecting the live birth rate in patients with RIF, adenomyosis, and myoma RIF Adenomyosis Myoma Adjusted OR (95% CI) p value Adjusted OR (95% CI) p value Adjusted OR (95% CI) p value Atosiban vs. control 2.17(1.08–4.35) 0.030 3.44(1.43–8.28) 0.006 3.11(1.23–7.85) 0.016 Age (years) 0.90(0.81–0.99) 0.035 0.80(0.70–0.91) 0.001 0.91(0.79–1.04) 0.147 BMI (kg/m 2 ) 0.98(0.89–1.07) 0.616 1.15(1.04–1.28) 0.008 1.02(0.89–1.16) 0.795 Infertility duration (years) 1.09(0.98–1.21) 0.124 1.11(0.97–1.26) 0.139 1.08(0.94–1.25) 0.271 Types of infertility 1.32(0.63–2.74) 0.460 0.82(0.36–1.87) 0.634 1.80(0.68–4.76) 0.233 AMH (ng/mL) 1.04(0.90–1.20) 0.607 0.84(0.71–1.01) 0.056 1.06(0.89–1.26) 0.497 Endometrial thickness (mm) 1.03(0.91–1.17) 0.632 1.06(0.89–1.27) 0.508 1.04(0.85–1.28) 0.706 HRT vs. Natural cycle 0.75(0.33–1.73) 0.505 0.40(0.15–1.10) 0.075 0.67(0.22–2.09) 0.489 Day 5 vs. Day 3 ET 1.56(0.76–3.22) 0.231 1.49(0.61–3.61) 0.379 1.17(0.46–2.94) 0.747 RIF, recurrent implantation failure; OR, odds ratio; CI, confidence interval; BMI, body mass index; AMH, anti-Müllerian hormone; HRT, hormone replacement therapy; ET, embryo transfer *Adjustment for age, BMI, infertility duration, type of infertility, AMH level, endometrial thickness, FET protocol, and day of ET Discussion This retrospective cohort study aimed to investigate the impact of an oxytocin receptor antagonist on live birth rates in infertile women undergoing IVF-FET, particularly focusing on subgroups with RIF, adenomyosis, and myoma. While there was no significant improvement in live birth rates in the overall population, noteworthy findings emerged in specific subgroups. Among patients with RIF (43.9% vs. 26.2%, P = 0.016), adenomyosis (37.7% vs. 22.1%, P = 0.039), or myoma (46.3% vs. 20.4%, P = 0.004), the study group demonstrated significantly greater live birth rates than did the control group. Multivariate analysis further revealed a positive association between the use of an oxytocin receptor antagonist and increased live birth rates in women with RIF (adjusted OR 2.17, 95% CI 1.08–4.35; P = 0.030), adenomyosis (adjusted OR 3.44, 95% CI 1.43–8.28; P = 0.006), and myoma (adjusted OR 3.11, 95% CI 1.23–7.85; P = 0.016). Several studies have suggested that the use of an oxytocin antagonist in IVF-ET for women with RIF improves reproductive outcomes [ 12 , 16 – 18 ]. In a meta-analysis comprising six studies, atosiban treatment was shown to increase the implantation rate, clinical pregnancy rate, and live birth rate in women undergoing their third or subsequent ET cycles. However, no statistically significant differences were observed in the subgroups of patients who underwent their first or second ET cycle [ 18 ]. In another meta-analysis involving three randomized controlled trials (RCTs) involving 510 women who had undergone two or more consecutive IVF-ET attempts, compared with those in the no-treatment group, the implantation rate, clinical pregnancy rate, and live birth rate were significantly greater in the atosiban group [ 12 ]. He and colleagues enrolled 536 patients who underwent IVF/ET using cryopreserved embryos and categorized them into one subgroup according to the number of previous ETs. One study revealed that serum oxytocin and PGF2α levels and uterine contractions were significantly greater in the third and subsequent ET groups than in the first and second ET groups [ 13 ]. A plausible theory is that patients with more previous failure cycles have undergone more instrumental procedures, potentially enhancing the endometrial autocrine/paracrine oxytocin/oxytocin receptor system and inducing a greater frequency of uterine contractions during subsequent ET attempts. Atosiban, by decreasing uterine contractions, might contribute to improvements in pregnancy outcomes in patients with RIF. The multivariate analysis in our study revealed a 2.17-fold increase in live birth rate (95% CI 1.08–4.35, P = 0.030) in RIF patients treated with atosiban compared to those not treated with atosiban. However, additional large-scale prospective studies are warranted to confirm these results. A study utilizing a mouse model of adenomyosis induced by tamoxifen revealed a greater frequency of uterine peristalsis and concurrent hyperresponsiveness to oxytocin in adenomyosis patients, potentially contributing to impaired embryo implantation and decreased fertility [ 14 ]. In a randomized control study involving women with endometriosis, the endometriosis group exhibited significantly greater serum oxytocin and PGF2α levels and uterine contractions than did the tubal factor infertility group [ 19 ]. Based on these findings, we hypothesized that the administration of an oxytocin receptor antagonist during embryo transfer may enhance IVF outcomes in women with adenomyosis. The present study demonstrated a 3.44-fold increase in live birth rate (95% CI 1.43–8.28, P = 0.006) in adenomyosis patients treated with atosiban compared to those not treated with atosiban. Moreover, a randomized controlled study involving women with endometriosis revealed higher clinical pregnancy and implantation rates in the atosiban treatment group than in the control group (58.3% versus 38.3% and 41.0% versus 23.4%, respectively) [ 19 ]. However, further large-scale prospective studies are needed to validate these results. Abnormal uterine peristalsis has been suggested as one of the pathogenic factors contributing to myoma-related infertility [ 20 – 22 ]. In a prospective study, infertile patients with uterine myomas were evaluated by MRI at the time of implantation, and no pregnancies were achieved in the group with high-frequency (≥ 2 times/3 min) uterine peristalsis [ 15 ]. Therefore, we hypothesize that the administration of an oxytocin receptor antagonist during ET may enhance IVF outcomes in women with myomas. Our study demonstrated a 3.11-fold increase in live birth rate (95% CI 1.23–7.85, P = 0.016) in myoma patients treated with atosiban compared to those not treated with atosiban. To the best of our knowledge, this is the first study to specifically focus on the application of atosiban in patients with uterine myomas during FET. However, further studies are needed to corroborate and expand upon our findings. The current study has several limitations. First, its major drawbacks include its small sample size and retrospective design. Caution should be exercised in interpreting data from subgroup analyses due to potential biases arising from the small population size. Larger-scale prospective studies are needed to validate and support the observed results. Additionally, embryo selection in this study was based on morphological grading rather than euploidy, as PGT-A is not widely employed in our center. Consequently, confounding effects from embryo aneuploidy cannot be excluded. Moreover, the decision to administer an oxytocin receptor antagonist was left to the discretion of the clinical physician, introducing a potential source of bias. In conclusion, the administration of an oxytocin receptor antagonist during FET did not improve live birth rates in the overall population but might enhance live birth rates in women with RIF, adenomyosis, or myoma. Abbreviations ET: embryo transfer; IVF: in vitro fertilization; RIF: recurrent implantation failure; AMH: Anti-Mullerian hormone; BMI: body mass index; HRT: hormone replacement therapy; OR: odds ratio; CI: confidence interval; RCT: randomized controlled trial Declarations Ethics approval and consent to participate The study conformed to the Declaration of Helsinki for Medical Research about human subjects. In addition, approval was obtained from the institutional review board at Kaohsiung Veterans General Hospital (identifier KSVGH23-CT5-06). The study was performed in accordance with the approved guidelines. Notably, the need for informed consent was waived by the Institutional Review Board of Kaohsiung Veterans General Hospital due to the retrospective nature of the study. Consent for publication Not applicable Availability of data and materials The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests The authors declare that they have no competing interests. Funding Not applicable Authors’ contributions KHT, PHL and LTL contributed to the conception and design of the study; PWL, CUC and YCC organized the database; CJL and LTL performed the statistical analysis; PWL wrote the first draft of the manuscript; and LTL wrote sections of the manuscript. All the authors contributed to manuscript revision and read and approved the submitted version. Acknowledgments Not applicable References Kuijsters NPM, Methorst WG, Kortenhorst MSQ, Rabotti C, Mischi M, Schoot BC. 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Application of atosiban in frozen-thawed cycle patients with different times of embryo transfers. Gynecol Endocrinol. 2016;32(10):811–5. Qu M, Lu P, Bellve K, Lifshitz LM, ZhuGe R. Mode Switch of Ca(2 +) Oscillation-Mediated Uterine Peristalsis and Associated Embryo Implantation Impairments in Mouse Adenomyosis. Front Physiol. 2021;12:744745. Yoshino O, Hayashi T, Osuga Y, Orisaka M, Asada H, Okuda S, Hori M, Furuya M, Onuki H, Sadoshima Y, et al. Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. Hum Reprod. 2010;25(10):2475–9. Lan VT, Khang VN, Nhu GH, Tuong HM. Atosiban improves implantation and pregnancy rates in patients with repeated implantation failure. Reprod Biomed Online. 2012;25(3):254–60. Chou PY, Wu MH, Pan HA, Hung KH, Chang FM. Use of an oxytocin antagonist in in vitro fertilization-embryo transfer for women with repeated implantation failure: a retrospective study. Taiwan J Obstet Gynecol. 2011;50(2):136–40. Li J, Chen Y, Wang A, Zhang H. A meta-analysis of atosiban supplementation among patients undergoing assisted reproduction. Arch Gynecol Obstet. 2017;296(4):623–34. He Y, Wu H, He X, Xing Q, Zhou P, Cao Y, Wei Z. Administration of atosiban in patients with endometriosis undergoing frozen-thawed embryo transfer: a prospective, randomized study. Fertil Steril. 2016;106(2):416–22. Don EE, Mijatovic V, Huirne JAF. Infertility in patients with uterine fibroids: a debate about the hypothetical mechanisms. Hum Reprod. 2023;38(11):2045–54. Somigliana E, Vercellini P, Daguati R, Pasin R, De Giorgi O, Crosignani PG. Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update. 2007;13(5):465–76. Zepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids. Best Pract Res Clin Obstet Gynecol. 2016;34:66–73. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3849849","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":266667886,"identity":"bd76e567-d950-4560-93b5-027833f298eb","order_by":0,"name":"Po-Wen Lin","email":"","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Po-Wen","middleName":"","lastName":"Lin","suffix":""},{"id":266667887,"identity":"7b134b4b-ed2e-4e7a-a477-cd459540ca65","order_by":1,"name":"Chyi-Uei Chern","email":"","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chyi-Uei","middleName":"","lastName":"Chern","suffix":""},{"id":266667888,"identity":"31675102-3d58-4287-8304-07ff3bb446cb","order_by":2,"name":"Chia-Jung Li","email":"","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Chia-Jung","middleName":"","lastName":"Li","suffix":""},{"id":266667889,"identity":"385b5c4a-861a-44a6-b6cc-2468480821c4","order_by":3,"name":"Pei-Hsuan Lin","email":"","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Pei-Hsuan","middleName":"","lastName":"Lin","suffix":""},{"id":266667890,"identity":"b4765042-d488-4258-8b9c-379fa78217aa","order_by":4,"name":"Yu-Chen Chen","email":"","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yu-Chen","middleName":"","lastName":"Chen","suffix":""},{"id":266667891,"identity":"dbf27250-42f9-4da2-8bcf-f558b6593067","order_by":5,"name":"Kuan-Hao Tsui","email":"","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kuan-Hao","middleName":"","lastName":"Tsui","suffix":""},{"id":266667892,"identity":"1a6502bd-10fb-4c52-9d19-e04d72e78d05","order_by":6,"name":"Li-Te Lin","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6ElEQVRIiWNgGAWjYBACPmYg8cCAgYefvfngAyCbh4+QFjZmoJ4EAwYZyZ5jyQYgLWwEtTCAtDAw2BjcyDGTgIgQ0sLOf/BBQsEdHoMzB8wqv+bYyQANefjoBn6HMRskGDzjkTzekHZbdlsy0GFsxsY5+LWwSSQYHObhO3Pg2G3JbcxALTxs0gS0sP8AaWG4kdhWLLmtnigtbAwgLQI3ktkYP247TJQWY7DDgIHMLM247TgPGzMBv/DzH3z44cOfw/b87P0fP/7cVg1kND98jE8LCmDmAZPEKgcBxh+kqB4Fo2AUjIIRAwCWuUAyQ7DZWQAAAABJRU5ErkJggg==","orcid":"","institution":"Kaohsiung Veterans General Hospital","correspondingAuthor":true,"prefix":"","firstName":"Li-Te","middleName":"","lastName":"Lin","suffix":""}],"badges":[],"createdAt":"2024-01-10 09:29:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3849849/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3849849/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49646334,"identity":"39fc46df-52de-4035-9d2f-e46982ed8ed7","added_by":"auto","created_at":"2024-01-15 21:03:37","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":21074,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStudy flow diagram\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eIVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection; FET, frozen embryo transfer; PGT-A, preimplantation genetic testing for aneuploidy; POI, primary ovarian insufficiency; TESE, testicular sperm extraction; IUA, intrauterine adhesion\u003c/p\u003e","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-3849849/v1/ce6a7f12ea7fc71e30260003.png"},{"id":52844726,"identity":"0f53b47a-815c-453c-8c40-f1e58d0829de","added_by":"auto","created_at":"2024-03-17 16:37:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":410649,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3849849/v1/f174ffd8-07e1-4f5c-9fe9-564c0798075e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Administration of Oxytocin Receptor Antagonist during Frozen Embryo Transfer: Potential Improvement in Live Birth Rates for Women with Recurrent Implantation Failure, Adenomyosis, and Myoma","fulltext":[{"header":"Introduction","content":"\u003cp\u003eUterine dynamics encompass uterine peristalsis, giving rise to endometrial waves during various phases of the menstrual cycle. During the luteal phase, the uterus assumes a quiescent state conducive to embryo implantation [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Embryo transfer (ET) constitutes the final critical stage of in vitro fertilization (IVF). Research indicates that heightened contraction activity at the time of ET in IVF cycles correlates negatively with successful pregnancies [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. A meta-analysis demonstrated the significant adverse effect of increased contraction frequency (\u0026gt;\u0026thinsp;3 contractions/minute) on pregnancy rates [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In a prospective cohort study, the nonpregnant group consistently exhibited a greater contraction frequency than the pregnant group [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Therefore, elevated uterine contractions during embryo implantation significantly diminish pregnancy rates, with higher contraction frequencies exacerbating this adverse impact.\u003c/p\u003e \u003cp\u003eOxytocin initiates contractions by binding to oxytocin receptors, primarily through elevating intracellular calcium and prostaglandin levels, resulting in uterine myometrium contractions and eventually leading to labor and delivery [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Oxytocin receptor antagonists, which mimic oxytocin with stronger receptor affinity, function by reducing prostaglandin production and calcium influx into cells, thereby inhibiting uterine contractions [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. While oxytocin receptor antagonists are commonly used for tocolysis [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], their application in treating ET is currently under investigation. Previous studies have indicated that administering oxytocin receptor antagonists during ET improves pregnancy outcomes. A Cochrane Review and a meta-analysis both suggested that intravenous oxytocin receptor antagonist administration improved clinical pregnancy rates in infertile women undergoing IVF-ET [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. However, further research is necessary to assess the impact of these factors on live birth rates.\u003c/p\u003e \u003cp\u003eWomen with recurrent implantation failure (RIF) reportedly exhibit heightened uterine peristalsis. The administration of oxytocin receptor antagonists during ET has demonstrated benefits in this cohort [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. Adenomyosis and myomas are also correlated with increased uterine peristalsis frequencies [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Our hypothesis posits that the administration of oxytocin receptor antagonists during ET may improve IVF outcomes in women with adenomyosis and myomas. However, there is a paucity of published studies on this subject, and data on live birth rates are lacking. Therefore, this study aimed to investigate the impact of oxytocin receptor antagonist use during frozen embryo transfer (FET) on live birth rates in infertile women, with a specific focus on subgroups, including RIF, adenomyosis, and myomas.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy design and participants\u003c/h2\u003e \u003cp\u003eThis retrospective cohort study was conducted at the Reproductive Medical Center of Kaohsiung Veterans General Hospital from January 2021 to December 2021. Approval for this study was obtained from the Institutional Review Board of Kaohsiung Veterans General Hospital (reference number: KSVGH23-CT5-06). Given its retrospective design, the need for consent was waived by the Institutional Review Board. Patient data were retrieved from electronic medical records and IVF treatment sheets within the study period. The inclusion criterion included patients who underwent their first IVF-FET cycle at our reproductive center, for a total of 431 patients. The exclusion criteria were as follows: (i)\u0026thinsp;\u0026ge;\u0026thinsp;46 years of age, (ii) underwent preimplantation genetic testing cycles for aneuploidy (PGT-A), (iii) were oocyte recipients, (iv) had primary ovarian insufficiency, (v) had a husband who underwent testicular sperm extraction, (vi) had congenital uterine anomalies or severe intrauterine adhesions, (vii) had cancer, and (viii) were lost to follow-up. Consequently, 389 patients were enrolled and divided into a study group and a control group. An oxytocin receptor antagonist was administered during the FET procedure in the study group but not in the control group. The decision to administer the oxytocin receptor antagonist depended on the clinical judgment of the physician. The study flow chart is depicted in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eIVF, in vitro fertilization; ICSI, intracytoplasmic sperm injection; FET, frozen embryo transfer; PGT-A, preimplantation genetic testing for aneuploidy; POI, primary ovarian insufficiency; TESE, testicular sperm extraction; IUA, intrauterine adhesion\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eTreatment protocol\u003c/h2\u003e \u003cp\u003eBoth the natural cycle and artificial cycle were used for endometrial preparation. In the natural cycle, patients were instructed to use ovulation kits starting from day 10 of their menstrual cycle. Once a positive result was obtained, consecutive blood tests for LH, progesterone, and estrogen were conducted to predict the ovulation day. In the artificial cycle, endometrial preparation involved daily oral estradiol (Ediol, 8 mg; Synmosa Biopharma Corporation, Hsinchu County, Taiwan) and estradiol gel (Oestrogel gel; Besins, Drogenbos, Belgium), which were initiated before cycle day 5. In the natural cycle, luteal phase support, including intravaginal gel (Crinone 8% gel, Merck Serono, Hertfordshire, UK) and oral dydrogesterone (Duphaston 40 mg, Abbott, Olst, the Netherlands), commenced once the ovulation day was confirmed. In the artificial cycle, supplementation began when the endometrial thickness reached at least 8 mm.\u003c/p\u003e \u003cp\u003eFollowing assisted hatching via laser zona drilling, the frozen-thawed embryos were transferred under transabdominal sonographic guidance. In the study group, atosiban (tractocile, 7.5 mg/ml; Ferring, Kiel, Germany) was administered as an intravenous bolus of 6.75 mg before EF, followed by a continuous infusion of the remaining dose (30.75 mg) in 100 mL of normal saline at a rate of 15.4 mg/h. The total administered dose was 37.5 mg, and the total administered duration was 2 hours. Progesterone supplementation was prescribed in both groups until 8\u0026ndash;10 gestational weeks after pregnancy was confirmed.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eOutcome measures\u003c/h2\u003e \u003cp\u003eThe primary outcome measure was the live birth rate, defined as the delivery of a viable fetus beyond 24 weeks of gestation. The secondary outcomes included the clinical pregnancy rate, ongoing pregnancy rate, and miscarriage rate. The clinical pregnancy rate was defined as the detection of a fetal heartbeat at 6\u0026ndash;7 weeks of gestation. The ongoing pregnancy rate referred to pregnancies beyond 12 weeks of gestation, while the miscarriage rate denoted pregnancy loss before 24 weeks of gestation.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe Kolmogorov\u0026ndash;Smirnov test was used to assess the normality of the distribution of continuous variables. The independent t test was used to evaluate quantitative variables. Categorical variables were examined using the chi-square test. Multivariate logistic regression was employed to identify independent effects in subgroups, with adjustments for various covariates, such as age, BMI, infertility duration, type of infertility, AMH level, endometrial thickness, FET protocol, and day of ET. The results are presented as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS) version 20.0 (Chicago, IL, USA), with a significance level set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eAs illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, among 998 IVF/ICSI cycles, 431 patients underwent their first IVF-FET cycle at our reproductive center. After excluding 42 patients, the remaining 389 patients were divided into a study group (n\u0026thinsp;=\u0026thinsp;162) and a control group (n\u0026thinsp;=\u0026thinsp;227).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e presents a comparison of the baseline characteristics of the study population. No significant differences were observed in terms of age, infertility duration, previous IVF attempts, type of infertility, cause of infertility, or AMH levels between the two groups. However, a greater BMI was noted in the control group than in the study group.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBaseline characteristics of patients who did or did not receive atosiban during frozen embryo transfer\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAtosiban\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;162)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;227)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.923\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody mass index (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.009\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfertility duration (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.4\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.219\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrevious IVF attempts(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.414\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.3%(62/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.6%(74/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.0%(34/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.3%(46/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e≧\u0026thinsp;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.7%(66/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.1%(107/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of infertility (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.725\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary infertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e47.5%(77/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.3%(112/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary infertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e52.5%(85/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50.7%(115/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCauses of infertility (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.218\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTubal factor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.3%(7/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.0%(16/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale factor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.1%(5/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8%(11/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.6%(14/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.2%(14/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCOS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.0%(21/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.4%(19/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndometriosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.5%(17/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.6%(15/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUterine factor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.9%(16/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.2%(30/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUnexplained\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.6%(22/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.7%(22/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMultiple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.0%(60/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.1%(100/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-M\u0026uuml;llerian hormone(ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.15\u0026thinsp;\u0026plusmn;\u0026thinsp;3.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.990\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe data are presented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and %.\u003c/p\u003e \u003cp\u003eIVF, in vitro fertilization; POR, poor ovarian responder; PCOS, polycystic ovarian syndrome\u003c/p\u003e \u003cp\u003eThe cycle characteristics and pregnancy outcomes of the study population are presented in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. No significant differences were observed regarding endometrial thickness, FET protocol, day of ET, style used during ET, or percentage of at least one top-quality embryo transferred between the two groups. The biochemical pregnancy rate, clinical pregnancy rate, ongoing pregnancy rate, live birth rate, and miscarriage rate were similar between the two groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCycle characteristics of patients with or without atosiban administration during frozen embryo transfer\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameters\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAtosiban\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;162)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;227)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndometrial thickness (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.9\u0026thinsp;\u0026plusmn;\u0026thinsp;2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.401\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProtocol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNatural cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.4% (33/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.1% (41/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRT cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79.6% (129/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.9% (186/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eET day (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.118\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay 3 ET\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55.6% (90/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e63.4% (144/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay 5 ET\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44.4% (72/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36.6% (83/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStyle use (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.6% (22/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.8% (20/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.135\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt least one top-quality embryos transferred (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79.0% (128/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e78.9% (179/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.970\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBiochemical pregnancy rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56.2% (91/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49.8% (113/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical pregnancy rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.8% (71/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39.6% (90/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.409\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOngoing pregnancy rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.7% (66/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35.7% (81/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.310\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLive birth rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.7% (66/162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.9% (77/227)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.169\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiscarriage rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.0% (5/71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.7% (15/90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe data are presented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and %.\u003c/p\u003e \u003cp\u003eHRT, hormone replacement therapy; ET, embryo transfer\u003c/p\u003e \u003cp\u003eThe study population was subsequently stratified into three subgroups: patients with RIF, patients with adenomyosis, and patients with myoma. Compared to those in the control group, the study group exhibited significantly greater ongoing pregnancy rates (RIF, 43.9% vs. 28%, P\u0026thinsp;=\u0026thinsp;0.032; adenomyosis, 37.7% vs. 22.1%, P\u0026thinsp;=\u0026thinsp;0.039; myoma, 46.3% vs. 20.4%, P\u0026thinsp;=\u0026thinsp;0.004) and live birth rates (RIF, 43.9% vs. 26.2%, P\u0026thinsp;=\u0026thinsp;0.016; adenomyosis, 37.7% vs. 22.1%, P\u0026thinsp;=\u0026thinsp;0.039; myoma, 46.3% vs. 20.4%, P\u0026thinsp;=\u0026thinsp;0.004). A lower miscarriage rate was observed in the study group within the RIF subgroup (3.3% vs. 20%, P\u0026thinsp;=\u0026thinsp;0.041) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cb\u003eBasic and cycle characteristics of patients with RIF, adenomyosis or myoma who underwent atosiban administration or not during frozen embryo transfer\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eParameter\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eRecurrent implantation failure\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c8\" namest=\"c5\"\u003e \u003cp\u003eAdenomyosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c12\" namest=\"c9\"\u003e \u003cp\u003eMyoma\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAtosiban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAtosiban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eAtosiban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePatients, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.9\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e39.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.760\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e39.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e40.3\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.332\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBody mass index (kg/m2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.2\u0026thinsp;\u0026plusmn;\u0026thinsp;4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24.6\u0026thinsp;\u0026plusmn;\u0026thinsp;4.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e23.0\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e23.3\u0026thinsp;\u0026plusmn;\u0026thinsp;3.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.747\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfertility duration (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.7\u0026thinsp;\u0026plusmn;\u0026thinsp;3.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.855\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.5\u0026thinsp;\u0026plusmn;\u0026thinsp;3.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.8\u0026thinsp;\u0026plusmn;\u0026thinsp;3.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e5.1\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of infertility (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.706\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.176\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary infertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45.5% (30/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.4% (60/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e44.9% (31/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e48.1% (37/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e48.1% (26/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e61.1% (33/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary infertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54.5% (36/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.6% (67/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e55.1% (38/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e51.9% (40/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e51.9% (28/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e38.9% (21/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-M\u0026uuml;llerian hormone (ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.98\u0026thinsp;\u0026plusmn;\u0026thinsp;2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.51\u0026thinsp;\u0026plusmn;\u0026thinsp;2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.78\u0026thinsp;\u0026plusmn;\u0026thinsp;2.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.50\u0026thinsp;\u0026plusmn;\u0026thinsp;2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.535\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.84\u0026thinsp;\u0026plusmn;\u0026thinsp;2.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e2.31\u0026thinsp;\u0026plusmn;\u0026thinsp;2.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.314\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndometrial thickness (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.6\u0026thinsp;\u0026plusmn;\u0026thinsp;3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.562\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.8\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.1\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10.3\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e10.4\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.958\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProtocol\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.952\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.571\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.653\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNatural cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25.8% (17/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.2% (28/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e23.2% (16/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27.3% (21/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e25.9% (14/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.2% (12/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRT cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e74.2% (49/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73.8% (79/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e76.8% (53/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e72.7% (56/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e74.1% (40/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e77.8% (42/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRate of ET day (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.157\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.743\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.046\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay 3 ET\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60.6% (40/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71.0% (76/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62.3% (43/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e64.9% (50/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e53.7% (29/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e72.2% (39/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay 5 ET\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39.4% (26/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.0% (31/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.7% (26/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e35.1% (27/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e46.3% (25/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e27.8% (15/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRate of at least one top-quality embryos transferred (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e80.3% (53/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75.7% (81/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.482\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e75.4% (52/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e72.7% (56/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.717\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e77.8% (42/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e72.2% (39/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.505\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBiochemical pregnancy rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56.1% (37/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45.8% (49/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.190\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.9% (42/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e39.0% (30/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e63.0% (34/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e35.2% (19/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eClinical pregnancy rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e45.5% (30/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.7% (35/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.093\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42.0% (29/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e23.4% (18/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e51.9% (28/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.2% (12/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOngoing pregnancy rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.9% (29/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.0% (30/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.7% (26/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.1% (17/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e46.3% (25/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e20.4% (11/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLive birth rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e43.9% (29/66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.2% (28/107)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e37.7% (26/69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e22.1% (17/77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.039\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e46.3% (25/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e20.4% (11/54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMiscarriage rate (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.3% (1/30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.0% (7/35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.3% (3/29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.6% (1/18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003e0.567\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e10.7% (3/28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e8.3% (1/12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e0.818\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe data are presented as the mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and %.\u003c/p\u003e \u003cp\u003eRIF, recurrent implantation failure; HRT, hormone replacement therapy; ET, embryo transfer\u003c/p\u003e \u003cp\u003eAs depicted in Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, a binary logistic regression analysis was conducted to assess the impact of atosiban on live birth rates within the RIF, adenomyosis, and myoma subgroups. Age, BMI, infertility duration, type of infertility, AMH level, endometrial thickness, FET protocol, and day of ET were considered confounding factors in this analysis. Multivariate analysis revealed that the use of atosiban was positively associated with live birth rates in women with RIF (adjusted OR 2.17, 95% CI 1.08\u0026ndash;4.35; P\u0026thinsp;=\u0026thinsp;0.030), adenomyosis (adjusted OR 3.44, 95% CI 1.43\u0026ndash; 8.28; P\u0026thinsp;=\u0026thinsp;0.006), and myoma (adjusted OR 3.11, 95% CI 1.23\u0026ndash;7.85; P\u0026thinsp;=\u0026thinsp;0.016).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eLogistic regression analyses of factors affecting the live birth rate in patients with RIF, adenomyosis, and myoma\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eRIF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eAdenomyosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eMyoma\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eAdjusted OR\u003c/p\u003e \u003cp\u003e(95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAtosiban vs. control\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.17(1.08\u0026ndash;4.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.030\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.44(1.43\u0026ndash;8.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.11(1.23\u0026ndash;7.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.016\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.90(0.81\u0026ndash;0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.80(0.70\u0026ndash;0.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.91(0.79\u0026ndash;1.04)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.147\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.98(0.89\u0026ndash;1.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.15(1.04\u0026ndash;1.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.02(0.89\u0026ndash;1.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.795\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfertility duration (years)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.09(0.98\u0026ndash;1.21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.11(0.97\u0026ndash;1.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.139\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.08(0.94\u0026ndash;1.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.271\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of infertility\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.32(0.63\u0026ndash;2.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.460\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.82(0.36\u0026ndash;1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.634\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.80(0.68\u0026ndash;4.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.233\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAMH (ng/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.04(0.90\u0026ndash;1.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.607\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.84(0.71\u0026ndash;1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.06(0.89\u0026ndash;1.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.497\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEndometrial thickness (mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.03(0.91\u0026ndash;1.17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.632\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.06(0.89\u0026ndash;1.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.508\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.04(0.85\u0026ndash;1.28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.706\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHRT vs. Natural cycle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.75(0.33\u0026ndash;1.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.40(0.15\u0026ndash;1.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.075\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.67(0.22\u0026ndash;2.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.489\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDay 5 vs. Day 3 ET\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.56(0.76\u0026ndash;3.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.49(0.61\u0026ndash;3.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.379\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.17(0.46\u0026ndash;2.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.747\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eRIF, recurrent implantation failure; OR, odds ratio; CI, confidence interval; BMI, body mass index; AMH, anti-M\u0026uuml;llerian hormone; HRT, hormone replacement therapy; ET, embryo transfer\u003c/p\u003e \u003cp\u003e*Adjustment for age, BMI, infertility duration, type of infertility, AMH level, endometrial thickness, FET protocol, and day of ET\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis retrospective cohort study aimed to investigate the impact of an oxytocin receptor antagonist on live birth rates in infertile women undergoing IVF-FET, particularly focusing on subgroups with RIF, adenomyosis, and myoma. While there was no significant improvement in live birth rates in the overall population, noteworthy findings emerged in specific subgroups. Among patients with RIF (43.9% vs. 26.2%, P\u0026thinsp;=\u0026thinsp;0.016), adenomyosis (37.7% vs. 22.1%, P\u0026thinsp;=\u0026thinsp;0.039), or myoma (46.3% vs. 20.4%, P\u0026thinsp;=\u0026thinsp;0.004), the study group demonstrated significantly greater live birth rates than did the control group. Multivariate analysis further revealed a positive association between the use of an oxytocin receptor antagonist and increased live birth rates in women with RIF (adjusted OR 2.17, 95% CI 1.08\u0026ndash;4.35; P\u0026thinsp;=\u0026thinsp;0.030), adenomyosis (adjusted OR 3.44, 95% CI 1.43\u0026ndash;8.28; P\u0026thinsp;=\u0026thinsp;0.006), and myoma (adjusted OR 3.11, 95% CI 1.23\u0026ndash;7.85; P\u0026thinsp;=\u0026thinsp;0.016).\u003c/p\u003e \u003cp\u003eSeveral studies have suggested that the use of an oxytocin antagonist in IVF-ET for women with RIF improves reproductive outcomes [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In a meta-analysis comprising six studies, atosiban treatment was shown to increase the implantation rate, clinical pregnancy rate, and live birth rate in women undergoing their third or subsequent ET cycles. However, no statistically significant differences were observed in the subgroups of patients who underwent their first or second ET cycle [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In another meta-analysis involving three randomized controlled trials (RCTs) involving 510 women who had undergone two or more consecutive IVF-ET attempts, compared with those in the no-treatment group, the implantation rate, clinical pregnancy rate, and live birth rate were significantly greater in the atosiban group [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. He and colleagues enrolled 536 patients who underwent IVF/ET using cryopreserved embryos and categorized them into one subgroup according to the number of previous ETs. One study revealed that serum oxytocin and PGF2α levels and uterine contractions were significantly greater in the third and subsequent ET groups than in the first and second ET groups [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. A plausible theory is that patients with more previous failure cycles have undergone more instrumental procedures, potentially enhancing the endometrial autocrine/paracrine oxytocin/oxytocin receptor system and inducing a greater frequency of uterine contractions during subsequent ET attempts. Atosiban, by decreasing uterine contractions, might contribute to improvements in pregnancy outcomes in patients with RIF. The multivariate analysis in our study revealed a 2.17-fold increase in live birth rate (95% CI 1.08\u0026ndash;4.35, P\u0026thinsp;=\u0026thinsp;0.030) in RIF patients treated with atosiban compared to those not treated with atosiban. However, additional large-scale prospective studies are warranted to confirm these results.\u003c/p\u003e \u003cp\u003eA study utilizing a mouse model of adenomyosis induced by tamoxifen revealed a greater frequency of uterine peristalsis and concurrent hyperresponsiveness to oxytocin in adenomyosis patients, potentially contributing to impaired embryo implantation and decreased fertility [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In a randomized control study involving women with endometriosis, the endometriosis group exhibited significantly greater serum oxytocin and PGF2α levels and uterine contractions than did the tubal factor infertility group [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Based on these findings, we hypothesized that the administration of an oxytocin receptor antagonist during embryo transfer may enhance IVF outcomes in women with adenomyosis. The present study demonstrated a 3.44-fold increase in live birth rate (95% CI 1.43\u0026ndash;8.28, P\u0026thinsp;=\u0026thinsp;0.006) in adenomyosis patients treated with atosiban compared to those not treated with atosiban. Moreover, a randomized controlled study involving women with endometriosis revealed higher clinical pregnancy and implantation rates in the atosiban treatment group than in the control group (58.3% versus 38.3% and 41.0% versus 23.4%, respectively) [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. However, further large-scale prospective studies are needed to validate these results.\u003c/p\u003e \u003cp\u003eAbnormal uterine peristalsis has been suggested as one of the pathogenic factors contributing to myoma-related infertility [\u003cspan additionalcitationids=\"CR21\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. In a prospective study, infertile patients with uterine myomas were evaluated by MRI at the time of implantation, and no pregnancies were achieved in the group with high-frequency (\u0026ge;\u0026thinsp;2 times/3 min) uterine peristalsis [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Therefore, we hypothesize that the administration of an oxytocin receptor antagonist during ET may enhance IVF outcomes in women with myomas. Our study demonstrated a 3.11-fold increase in live birth rate (95% CI 1.23\u0026ndash;7.85, P\u0026thinsp;=\u0026thinsp;0.016) in myoma patients treated with atosiban compared to those not treated with atosiban. To the best of our knowledge, this is the first study to specifically focus on the application of atosiban in patients with uterine myomas during FET. However, further studies are needed to corroborate and expand upon our findings.\u003c/p\u003e \u003cp\u003eThe current study has several limitations. First, its major drawbacks include its small sample size and retrospective design. Caution should be exercised in interpreting data from subgroup analyses due to potential biases arising from the small population size. Larger-scale prospective studies are needed to validate and support the observed results. Additionally, embryo selection in this study was based on morphological grading rather than euploidy, as PGT-A is not widely employed in our center. Consequently, confounding effects from embryo aneuploidy cannot be excluded. Moreover, the decision to administer an oxytocin receptor antagonist was left to the discretion of the clinical physician, introducing a potential source of bias.\u003c/p\u003e \u003cp\u003eIn conclusion, the administration of an oxytocin receptor antagonist during FET did not improve live birth rates in the overall population but might enhance live birth rates in women with RIF, adenomyosis, or myoma.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eET: embryo transfer; IVF: in vitro fertilization; RIF: recurrent implantation failure; AMH: Anti-Mullerian hormone; BMI: body mass index; HRT: hormone replacement therapy; OR: odds ratio; CI: confidence interval; RCT: randomized controlled trial\u003c/p\u003e\n"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study conformed to the Declaration of Helsinki for Medical Research about human subjects. In addition, approval was obtained from the institutional review board at Kaohsiung Veterans General Hospital\u0026nbsp;(identifier KSVGH23-CT5-06). The study was performed in accordance with\u0026nbsp;the approved guidelines.\u0026nbsp;Notably, the need for informed consent was waived by the Institutional Review Board of Kaohsiung Veterans General Hospital due to the retrospective nature of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKHT, PHL and LTL contributed to the conception and design of the study; PWL, CUC and YCC organized the database; CJL and LTL performed the statistical analysis; PWL wrote the first draft of the manuscript;\u0026nbsp;and LTL wrote sections of the manuscript. All\u0026nbsp;the authors contributed to manuscript revision and read and approved the submitted version.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKuijsters NPM, Methorst WG, Kortenhorst MSQ, Rabotti C, Mischi M, Schoot BC. Uterine peristalsis and fertility: current knowledge and future perspectives: a review and meta-analysis. Reprod Biomed Online. 2017;35(1):50\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFanchin R, Righini C, Olivennes F, Taylor S, de Ziegler D, Frydman R. Uterine contractions at the time of embryo transfer alter pregnancy rates after in vitro fertilization. Hum Reprod. 1998;13(7):1968\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhu L, Che HS, Xiao L, Li YP. Uterine peristalsis before embryo transfer affects the chance of clinical pregnancy in fresh and frozen-thawed embryo transfer cycles. Hum Reprod. 2014;29(6):1238\u0026ndash;43.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChung CH, Wong AW, Chan CP, Saravelos SH, Kong GW, Cheung LP, Chung JP, Li TC. The changing pattern of uterine contractions before and after fresh embryo transfer and its relation to clinical outcome. Reprod Biomed Online. 2017;34(3):240\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShmygol A, Gullam J, Blanks A, Thornton S. Multiple mechanisms involved in oxytocin-induced modulation of myometrial contractility. Acta Pharmacol Sin. 2006;27(7):827\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArrowsmith S, Wray S. Oxytocin: its mechanism of action and receptor signaling in the myometrium. J Neuroendocrinol. 2014;26(6):356\u0026ndash;69.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShubert PJ. Atosiban. Clin Obstet Gynecol. 1995;38(4):722\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMelin P. Oxytocin antagonists in preterm labor and delivery. Baillieres Clin Obstet Gynecol. 1993;7(3):577\u0026ndash;600.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVrachnis N, Malamas FM, Sifakis S, Deligeoroglou E, Iliodromiti Z. The oxytocin-oxytocin receptor system and its antagonists as tocolytic agents. Int J Endocrinol. 2011;2011:350546.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChandraharan E, Arulkumaran S. Acute tocolysis. Curr Opin Obstet Gynecol. 2005;17(2):151\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCraciunas L, Tsampras N, Kollmann M, Raine-Fenning N, Choudhary M. Oxytocin antagonists for assisted reproduction. Cochrane Database Syst Rev. 2021;9(9):CD012375.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHuang QY, Rong MH, Lan AH, Lin XM, Lin XG, He RQ, Chen G, Li MJ. The impact of atosiban on pregnancy outcomes in women undergoing in vitro fertilization-embryo transfer: A meta-analysis. PLoS ONE. 2017;12(4):e0175501.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHe Y, Wu H, He X, Xing Q, Zhou P, Cao Y, Wei Z. Application of atosiban in frozen-thawed cycle patients with different times of embryo transfers. Gynecol Endocrinol. 2016;32(10):811\u0026ndash;5.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQu M, Lu P, Bellve K, Lifshitz LM, ZhuGe R. Mode Switch of Ca(2 +) Oscillation-Mediated Uterine Peristalsis and Associated Embryo Implantation Impairments in Mouse Adenomyosis. Front Physiol. 2021;12:744745.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYoshino O, Hayashi T, Osuga Y, Orisaka M, Asada H, Okuda S, Hori M, Furuya M, Onuki H, Sadoshima Y, et al. Decreased pregnancy rate is linked to abnormal uterine peristalsis caused by intramural fibroids. Hum Reprod. 2010;25(10):2475\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLan VT, Khang VN, Nhu GH, Tuong HM. Atosiban improves implantation and pregnancy rates in patients with repeated implantation failure. Reprod Biomed Online. 2012;25(3):254\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChou PY, Wu MH, Pan HA, Hung KH, Chang FM. Use of an oxytocin antagonist in in vitro fertilization-embryo transfer for women with repeated implantation failure: a retrospective study. Taiwan J Obstet Gynecol. 2011;50(2):136\u0026ndash;40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi J, Chen Y, Wang A, Zhang H. A meta-analysis of atosiban supplementation among patients undergoing assisted reproduction. Arch Gynecol Obstet. 2017;296(4):623\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHe Y, Wu H, He X, Xing Q, Zhou P, Cao Y, Wei Z. Administration of atosiban in patients with endometriosis undergoing frozen-thawed embryo transfer: a prospective, randomized study. Fertil Steril. 2016;106(2):416\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDon EE, Mijatovic V, Huirne JAF. Infertility in patients with uterine fibroids: a debate about the hypothetical mechanisms. Hum Reprod. 2023;38(11):2045\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSomigliana E, Vercellini P, Daguati R, Pasin R, De Giorgi O, Crosignani PG. Fibroids and female reproduction: a critical analysis of the evidence. Hum Reprod Update. 2007;13(5):465\u0026ndash;76.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids. Best Pract Res Clin Obstet Gynecol. 2016;34:66\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Oxytocin receptor antagonist, atosiban, frozen embryo transfer, recurrent implantation failure, adenomyosis, myoma, in vitro fertilization","lastPublishedDoi":"10.21203/rs.3.rs-3849849/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3849849/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe primary objective of this investigation was to assess the potential improvement in pregnancy outcomes among infertile women undergoing in vitro fertilization (IVF) cycles, specifically during frozen embryo transfer (FET), following the administration of an oxytocin receptor antagonist. This study aimed to examine this impact across various subgroups, including individuals experiencing recurrent implantation failure (RIF), adenomyosis, and myoma.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis retrospective cohort study involved 431 patients who underwent their initial IVF-FET cycle at our reproductive center between January and December 2021. The study group (n\u0026thinsp;=\u0026thinsp;162) received an oxytocin receptor antagonist during FET, while the control group (n\u0026thinsp;=\u0026thinsp;227) underwent FET without this antagonist. A comparative analysis of baseline and cycle characteristics was conducted between the two groups, with additional subgroup analyses.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThere were no significant differences in baseline or cycle characteristics between the study and control groups. Overall, there was no significant difference in live birth rate between the two groups. However, in specific subgroups, the study group demonstrated significantly greater live birth rates than did the control group for patients with RIF (43.9% vs. 26.2%, P\u0026thinsp;=\u0026thinsp;0.016), adenomyosis (37.7% vs. 22.1%, P\u0026thinsp;=\u0026thinsp;0.039), or myoma (46.3% vs. 20.4%, P\u0026thinsp;=\u0026thinsp;0.004). Multivariate analysis indicated a positive association between oxytocin receptor antagonist use and live birth rates in women with RIF (adjusted OR 2.17, 95% CI 1.08\u0026ndash;4.35; P\u0026thinsp;=\u0026thinsp;0.030), adenomyosis (adjusted OR 3.44, 95% CI 1.43\u0026ndash;8.28; P\u0026thinsp;=\u0026thinsp;0.006), and myoma (adjusted OR 3.11, 95% CI 1.23\u0026ndash;7.85; P\u0026thinsp;=\u0026thinsp;0.016).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eWhile the administration of an oxytocin receptor antagonist during FET did not increase live birth rates in the overall population, it exhibited potential benefits in improving live birth rates in women with RIF, adenomyosis, or myoma.\u003c/p\u003e","manuscriptTitle":"Administration of Oxytocin Receptor Antagonist during Frozen Embryo Transfer: Potential Improvement in Live Birth Rates for Women with Recurrent Implantation Failure, Adenomyosis, and Myoma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-15 21:03:33","doi":"10.21203/rs.3.rs-3849849/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e04796ef-5718-4241-bc5c-c1e87e1b7050","owner":[],"postedDate":"January 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-17T16:29:42+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-15 21:03:33","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3849849","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3849849","identity":"rs-3849849","version":["v1"]},"buildId":"0U-iFTyB6qxOgVj8rjrZV","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}