Overcoming adenomyosis in in vitro fertilization: a case series

Adenomyosis is increasingly diagnosed in infertile women and is associated with adverse in vitro fertilization (IVF) outcomes. Individualizing ovarian stimulation and embryo transfer strategies may improve reproductive outcomes. This retrospective case series includes three women with imaging-confirmed adenomyosis who underwent IVF using a gonadotropin-releasing hormone (GnRH) antagonist protocol with a freeze-all strategy, followed by frozen embryo transfer (FET). Clinical characteristics, stimulation parameters, embryological outcomes, and pregnancy outcomes were evaluated. All patients completed ovarian stimulation with satisfactory oocyte yield and embryo development. Frozen embryo transfer was performed following GnRH agonist down-regulation and hormone replacement therapy. All three patients achieved ongoing clinical pregnancy. Favorable IVF outcomes can be achieved in women with adenomyosis using an antagonist protocol combined with a freeze-all strategy and frozen embryo transfer. Larger prospective studies are required to validate these findings.