The "freeze-all" strategy seems to improve the chances of birth in adenomyosis-affected women
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This study investigated the impact of the "freeze-all" embryo transfer strategy on pregnancy outcomes for women diagnosed with adenomyosis.
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Abstract
OBJECTIVE: To compare assisted reproductive technologies (ARTs) outcomes between fresh vs. freeze-all strategies in infertile women affected by adenomyosis.
DESIGN: A single-center observational study.
SETTINGS: University hospital-based research center.
PATIENTS: Adenomyosis-affected women undergoing blastocyst embryo transfer after in vitro fertilization and intracytoplasmic sperm injection between January 1, 2018, and November 31, 2021. The diagnosis of adenomyosis was based on imaging criteria (i.e., transvaginal ultrasound and/or magnetic resonance imaging).
INTERVENTION(S): Women who underwent a freeze-all strategy were compared with those who underwent a fresh embryo transfer (ET) strategy.
MAIN OUTCOME MEASURE(S): Cumulative live birth rate (LBR).
RESULTS: A total of 306 women were included in the analysis: 111 in the fresh ET group and 195 in the freeze-all group. The adenomyosis phenotype (internal diffuse adenomyosis, external focal adenomyosis, and adenomyoma) was not significantly different between the two groups. The cumulative LBR (86 [44.1%] vs. 34 [30.6%], respectively), and the cumulative ongoing pregnancy rate (88 [45.1%] vs. 36 [32.4%], respectively) were significantly higher in the freeze-all group compared with the fresh ET group. After multivariate logistic regression analysis, the freeze-all strategy in women with adenomyosis was associated with significantly higher odds of live birth compared with fresh ET (odds ratio = 1.80; 95% confidence interval = 1.02-3.16).
CONCLUSION: The freeze-all strategy in women afflicted with adenomyosis undergoing ART was associated with significantly higher cumulative LBRs. Our preliminary results suggest that the freeze-all strategy is an attractive option that increases ART success rates. Additional studies, with a randomized design, should be conducted to further test whether the freeze-all strategy enhances the pregnancy rate in adenomyosis-affected women.
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Cited by (9)
- Clinical challenges and therapeutic strategies in women with endometriosis, deep infiltrating endometriosis, and/or adenomyosis undergoing assisted reproductive technologies: a narrative review 2026
- Adenomyosis and fertility: from pathophysiology to optimizing reproductive outcomes 2026
- Effect of focal adenomyosis on pregnancy outcomes: retrospective propensity score matching analysis of 13,186 IVF/ICSI cycles 2026
- Strategies to Improve Assisted Reproductive Technique Outcomes in Women with Adenomyosis: A Narrative Review 2025
- Endométriose : un nouveau paradigme pour le diagnostic et le traitement 2025
- Cumulative live birth rates under three consecutive IVF/ICSI treatment cycles are reduced in women with endometriosis and/or adenomyosis diagnosed by ultrasonography 2025
- Does frozen embryo transfer improve pregnancy outcomes in patients with ovarian endometriosis? A retrospective cohort study 2025
- Peri-implantation treatment with TNF-α inhibitor for endometriosis and/or adenomyosis women undergoing frozen-thawed embryo transfer: A retrospective cohort study 2024
- The Art of Managing Infertile Patients with Adenomyosis 2024
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