Peri-implantation treatment with TNF-α inhibitor for endometriosis and/or adenomyosis women undergoing frozen-thawed embryo transfer: A retrospective cohort study

Mengqi Liu, Yan Li, Li Yan, Yuan Yuan, Min Jiang, Ping Yin, Dongzi Yang
Journal of reproductive immunology · 2024 · vol. 167 , pp. 104415 · doi:10.1016/j.jri.2024.104415 · PMID:39700679 · W4405260755
article OA: hybrid CC0 ⤵ 4 in-corpus citations
🔓 Open OA copy View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Peri-implantation treatment with adalimumab improved implantation and clinical pregnancy rates in women with endometriosis/adenomyosis undergoing frozen-thawed embryo transfer.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

Abstract

Endometriosis and adenomyosis have common pathogenesis and close relationship, with multi-factors involved in related infertility and IVF failure. They lead to anatomical changes, ovarian reserve reduction, endocrine abnormalities, altered endometrial receptivity and immunological dysfunction. Collective evidence indicate that abnormal function of immune cells and secretion of cytokines are closely related to reproductive outcomes among the women. Some studies showed that increased secretion of tumor necrosis factor alpha (TNF-α) led a key role in pro-inflammatory response in women with endometriosis/adenomyosis.TNF-a is embrryotoxic and receptivity impairing. Therefore, immunotherapy is a targeted therapeutic strategy apart from routine treatment. TNF-α inhibitors such as etanercept and adalimumab were shown to reduce the embryotoxic and anti-inflammatory effects to increase IVF pregnancy rates in recurrent implantation failure or endometrioma patient. However, there’s no evidence about the use of adalimumab for patients with endometriosis and/or adenomyosis undergoing Frozen embryo transfer(FET). A retrospective analysis of 141 women with endometriosis and/or adenomyosis undergoing FET from January 2021 to Jun 2023 was conducted.They were 20 to 42 years old, with or without previous implantation failure. Endometriosis was diagnosed by laparoscopy during their infertility workup and adenomyosis was confirmed by vaginal ultrasound screening. GnRH agonist and hormone replacement treatment (HRT) or HRT were taken for endometrium preparation according to doctor’s evaluation and preference. Before and after embryo transfer, 84 women were treated with Adalimumab and 57 patients were untreated. Implantation rate, clinical pregnancy rate, ongoing pregnancy rate and live birth rate were compared between the two groups. The demographics and baseline characteristics between the two groups were comparable. Stage of embryo transferred and number of embryo transferred were comparable between the two groups (p=0.227 and p=0.204 separately). The regimen of endometrium preparation was similar too(p=0.907). The implantation rate was significantly improved in study group (28.09% vs 49.18%, X 2 =9.515, P=0.002). The clinical pregnancy rate was much lower in control group comparing with TNF-α inhibitor treatment group (42.11% vs 60.71%, X 2 =4.723, P=0.029). There was no significant difference between the two groups as for ongoing pregnancy rate (38.60% vs 52.38%, X 2 =2.591, P=0.107)and live birth rate (36.84% vs 47.62%, X 2 =1.606, P=0.205). Following adjustment for age, BMI, number of prior failed transfer, stage of embryo transferred in a multiple logistic analysis, patients treated without TNF-α inhibitor had a significant lower CPR (ORadj 0.45, 95%CI 0.22-0.92, p=0.029) and a similar probability for OPR (ORadj 0.56, 95%CI 0.28-1.12) and LBR (ORadj 0.62, 95%CI 0.31-1.26) as compared with patients with TNF-α inhibitor treatment. However, an obvious trend of improvement of LBR was observed and it’s clinical relevant for the patients. In women with endometriosis and/or adenomyosis, peri-implantation treatment with TNF-α inhibitor increased implantation rate and clinical pregnancy rate significantly compared with control group in FET cycles. The ongoing pregnancy rate and live birth rate were not significant different, while the difference was clinical relevant. • Immunotherapy is a novel therapeutic strategy of endometriosis and adenomyosis. • TNF-α inhibitors were shown to reduce the embryotoxic and anti-inflammatory effects to increase IVF pregnancy rates in recurrent implantation failure or endometrioma patient. • For endometriosis and adenomyosis women, peri-implantation treatment with TNF-α inhibitor(Adalimumab) significantly increased implantation rate and clinical pregnancy rate in FET cycles. • The ongoing pregnancy rate and live birth rate were not significant different, while the difference was clinical relevant.

My notes (saved in your browser only)

Condition tags

mesh:D004715endometriosisadenomyosisendometriomainfertility

MeSH descriptors

Adalimumab Adalimumab Adalimumab Adalimumab Adalimumab Adalimumab Adalimumab Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Embryo Transfer Embryo Transfer Embryo Transfer Embryo Transfer Embryo Transfer

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (46)

Cited by (4)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-16T00:31:57.365633+00:00
License: CC0 · commercial use OK