Pregnancy rate in women with adenomyosis undergoing fresh or frozen embryo transfer cycles following gonadotropin-releasing hormone agonist treatment

Chan Woo Park, Min Hye Choi, Kwang Moon Yang, In Ok Song
Clinical and experimental reproductive medicine · 2016 · vol. 43(3) , pp. 169 · doi:10.5653/cerm.2016.43.3.169 · PMID:27689040 · PMC5039310 · W2526935097
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Frozen embryo transfer cycles following GnRH agonist treatment showed a trend towards higher pregnancy rates in women with adenomyosis compared to fresh transfer cycles.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This retrospective study evaluated IVF outcomes in 241 infertile women with adenomyosis across 241 patients and 295 total cycles, comparing fresh embryo transfer (ET) without GnRH agonist pretreatment, fresh ET with GnRH agonist pretreatment, and frozen-thawed ET (FET) following GnRH agonist treatment. Adenomyosis was diagnosed and classified by transvaginal ultrasound, and the authors compared stimulation parameters and outcomes including retrieved oocytes, maturation/fertilization rates, clinical pregnancy rate, and miscarriage rate. GnRH agonist pretreatment in fresh ET increased stimulation duration, total gonadotropin dose, and the number of retrieved oocytes, while FET after GnRH agonist led to a higher number of retrieved oocytes with a lower gonadotropin dose; clinical pregnancy rates tended to be higher with FET but differences were not statistically significant. The study’s limitation was that it was retrospective and used a relatively small FET group, leading to the need for further large-scale prospective confirmation. This paper is centrally about adenomyosis — comparing IVF regimen outcomes with GnRH agonist pretreatment versus FET in women with adenomyosis.

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Abstract

OBJECTIVE: To determine the preferred regimen for women with adenomyosis undergoing in vitro fertilization (IVF), we compared the IVF outcomes of fresh embryo transfer (ET) cycles with or without gonadotropin-releasing hormone (GnRH) agonist pretreatment and of frozen-thawed embryo transfer (FET) cycles following GnRH agonist treatment. METHODS: This retrospective study included 241 IVF cycles of women with adenomyosis from January 2006 to January 2012. Fresh ET cycles without (147 cycles, group A) or with (105 cycles, group B) GnRH agonist pretreatment, and FET cycles following GnRH agonist treatment (43 cycles, group C) were compared. Adenomyosis was identified by using transvaginal ultrasound at the initial workup and classified into focal and diffuse types. The IVF outcomes were also subanalyzed according to the adenomyotic region. RESULTS: GnRH agonist pretreatment increased the stimulation duration (11.5±2.1 days vs. 9.9±2.0 days) and total dose of gonadotropin (3,421±1,141 IU vs. 2,588±1,192 IU), which resulted in a significantly higher number of retrieved oocytes (10.0±8.2 vs. 7.9±6.8, p=0.013) in group B than in group A. Controlled ovarian stimulation for freezing resulted in a significantly higher number of retrieved oocytes (14.3±9.2 vs. 10.0±8.2, p=0.022) with a lower dose of gonadotropin (2,974±1,112 IU vs. 3,421±1,141 IU, p=0.037) in group C than in group B. The clinical pregnancy rate in group C (39.5%) tended to be higher than those in groups B (30.5%) and A (25.2%) but without a significant difference. CONCLUSION: FET following GnRH agonist pretreatment tended to increase the pregnancy rate in patients with adenomyosis. Further large-scale prospective studies are required to confirm this result.

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adenomyosis

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