Does Adenomyosis Influence ICSI Clinical Outcome? A Systematic Analysis and Impact of GnRH Agonist Pretreatment for Women with Adenomyosis in ICSI-FET Cycle: A Retrospective Cohort Study

Pradeepa Sudhakar, Saranya Manivannan, Dhanabagyam Kandasamy, Kavitha Jayapal
Journal of obstetrics and gynaecology of India · 2021 · vol. 72(3) , pp. 236–242 · doi:10.1007/s13224-021-01504-y · PMID:35734352 · PMC9206983 · W3173342225
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-08 ⓘ

Adenomyosis negatively impacts ICSI/FET cycle outcomes, but GnRH agonist pretreatment or surgery improved pregnancy rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective cohort study analyzed 613 ICSI cycles from 2018–2020 at a single infertility center, focusing on 235 women diagnosed with adenomyosis undergoing ICSI-FET and comparing outcomes across different pretreatment approaches. The key findings were that women with adenomyosis had lower clinical pregnancy rates, higher miscarriage rates, and lower ongoing pregnancy/live birth measures after ICSI-FET. Among adenomyosis patients, clinical pregnancy rate improved significantly with GnRH agonist pretreatment, conservative surgery, or combination therapy (including a GnRH agonist long protocol). Limitations include its retrospective, single-center design and the need for larger prospective comparative studies to confirm the results. This paper is centrally about adenomyosis — it evaluates how adenomyosis affects ICSI-FET pregnancy outcomes and whether GnRH agonist pretreatment and/or conservative surgery modifies that outcome.

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Abstract

OBJECTIVE: To evaluate the impact of adenomyosis on pregnancy outcome in ICSI/FET cycles and the beneficial effect of GnRH agonist pretreatment, conservative surgery or combination therapy on pregnancy outcome. MATERIALS AND METHODS: This is a retrospective cohort study where 613 ICSI cycles done in the period from Jan 2018 to Dec 2020 in Sudha infertility centre, Erode were analyzed. Study populations include 235 women with adenomyosis undergoing ICSI/FET cycle. RESULT: Overall, the outcome in terms of clinical pregnancy rate, miscarriage rate, live birth date and ongoing pregnancy rate was lower in women with adenomyosis following ICSI/FET cycles. We found significant improvement in clinical pregnancy rate who had pretreatment with GnRH agonist, conservative surgery or combination therapy. CONCLUSION: Adenomyosis as such has detrimental effect on ICSI clinical outcome. Pretreatment with GnRH agonist and conservative surgery and GnRH agonist long protocol could be beneficial. Further large scale prospective comparative studies are needed to confirm this result.

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adenomyosis

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