Clin Exp Reprod Med.  2016 Sep;43(3):169-173. 10.5653/cerm.2016.43.3.169.

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

• Park CW
• Choi MH
• Yang KM
• Song IO

• KMID: 2352851
• DOI: http://doi.org/10.5653/cerm.2016.43.3.169

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.

Keyword

Adenomyosis; Embryo transfer; Gonadotorpin-releasing hormone; In vitro fertilization

MeSH Terms

Adenomyosis*
Embryo Transfer*
Embryonic Structures*
Female
Fertilization in Vitro
Freezing
Gonadotropin-Releasing Hormone*
Gonadotropins
Humans
Oocytes
Ovulation Induction
Pregnancy Rate*
Pregnancy*
Prospective Studies
Retrospective Studies
Ultrasonography
Gonadotropin-Releasing Hormone
Gonadotropins