Clinical outcomes after single-versus double-embryo transfers in women with adenomyosis: a retrospective study

Background Adenomyosis affects the outcomes of spontaneous fertility and assisted reproductive technology. The single blastocyst embryo transfer (SBT) policy is an effective strategy known to minimize the risk of multiple pregnancy for non-adenomyosis women. However, little is known about its applicability to women with adenomyosis. The purpose of this study is to compare pregnancy outcomes between SBT, double-blastocyst embryo transfer (DBT), single-cleavage-stage embryo transfer (SET) and double-cleavage-stage embryo transfer (DET) in the frozen–thawed embryo transfer cycles among adenomyosis patients.

This retrospective study was conducted in all frozen–thawed autologous embryo transfer cycles. 393 frozen–thawed embryo transfer cycles performed in adenomyosis patients were enrolled. The major clinical outcomes were implantation rate (IR), clinical pregnancy rate (CPR), miscarriage rate (MR), multiple pregnancy rate (MPR) and live birth rate (LBR).

The SBT and DBT groups achieved higher IR (P < 0.001), CPR (P = 0.017), LBR (P = 0.040) and lower MR (P = 0.020) than the SET and DET groups. But the SBT and DBT groups achieved similar CPR and LBR. The SBT and SET groups achieved lower MPR (P < 0.001) than the DBT and DET groups. The average birth weight (BW) of SBT groups was higher than the DBT and DET groups (P = 0.016). When compared with SBT group, low-birth-weight infants were significantly higher with DBT and DET.

When performing frozen–thawed embryo transfer cycles among adenomyosis patients, the SBT group has similar IR, CPR, MR, LBR but lower MPR compared to the DBT group. Therefore, SBT might be offered as standard practice. Similar content being viewed by others Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Abbreviations - AMH: - Anti-Mullerian hormone - ASRM: - The American Society for Reproductive Medicine - BMI: - Body mass index - BPR: - Biochemical pregnancy rate - BW: - Birth weight - COH: - Controlled ovarian hyperstimulation - COS: - Controlled ovarian stimulation - CPR: - Clinical pregnancy rate - DBT: - Double-blastocyst embryo transfer - DET: - Double-cleavage-stage embryo transfer - eNOS: - Endothelial nitric oxide synthase - GnRH-a: - Gonadotropin-releasing hormone agonist - hCG: - Human chorionic gonadotropin - HRT: - Hormone replacement treatment - ICIS: - Intracytoplasmic sperm injection - IR: - Implantation rate - IVF: - In vitro fertilization - LBR: - Live birth rate - MPR: - Multiple pregnancy rate - MR: - Miscarriage rate - PBR: - Preterm birth rate - SBT: - Single-blastocyst embryo transfer - SET: - Single-cleavage-stage embryo transfer - VEGF: - Vascular endothelial growth factor

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Not applicable. Funding This work was supported by the Science and Technology Program of Guangdong Province (2014A020213002) and the Free Application Project of Guangdong Natural Science Foundation (2015A030313131). Author information Authors and Affiliations Contributions JG and ZZ designed the study. ML and JH were responsible for the data collection and checking. JG performed the data analysis and manuscript drafting. JP, MW and XL dealt with data visualization. HZ supervised the project administration. Corresponding author Ethics declarations Conflict of interest statement The authors have no conflicts of interest to declare. Ethics approval This study was approved by the ethics committee of the Sixth Affiliated Hospital of Sun Yat-sen University. Informed consent The requirement of informed consent was waived by the ethics committee because of the retrospective nature of the study. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions About this article Cite this article Guo, J., Zeng, Z., Li, M. et al. Clinical outcomes after single-versus double-embryo transfers in women with adenomyosis: a retrospective study. Arch Gynecol Obstet 304, 263–270 (2021). https://doi.org/10.1007/s00404-020-05924-5 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00404-020-05924-5