Long-term GnRH agonist pretreatment before frozen embryo transfer improves pregnancy outcomes in women with adenomyosis

Wu, Yingchen; Huang, Jian; Zhong, Guangzheng; Lan, Jie; Lin, Haifan; Zhang, Qingxue

doi:10.1016/j.rbmo.2021.10.014

Cited by 19 publications

(25 citation statements)

References 49 publications

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“…The rates of BPR, MR, early MR and late MR were similar among ultra-long, long and antagonist protocols. Thalluri V. reported CPR in antagonist protocol was 23.6% in patients with adenomyosis, which was similar to our data and significantly lower than the reported CPR in ultra-long or long protocols (6)(7)(8)15) . Kolanska K compared pregnancy outcomes of GnRH-agonist versus GnRH-antagonist protocols in women with endometriosis-associated infertility and inferred GnRH-antagonist associated dysfunction of endometrial receptivity might result in decreased CPR and LBR (16) .…”

Section: Characteristics Of Antagonist Protocol In Fresh Et Cycles An...supporting

confidence: 91%

“…The negative effect of adenomyosis on outcomes of ART were accumulated, and persistent endeavors were made to improve the pregnancy outcomes (3)(4)(5) . So far, ultr-along protocol had received more approvement because of possible improvement on clinical pregnancy rate(CPR) or live birth rate(LBR) (6)(7)(8)(9) . A widely accepted mechanism was downregulation induced by long acting GnRHa could counter hyperestrogenism and progesterone resistance of adeomyosis.…”

Section: Introductionmentioning

confidence: 99%

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Effects of different ovarian stimulation protocols on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with adenomyosis: a retrospective cohort study

Ge¹,

Cui

et al. 2022

Preprint

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Objective: to evaluate effects of different ovarian stimulation protocols on in vitro fertilization(IVF) or intracytoplasmic sperm injection (ICSI) outcomes in infertile women with adenomyosis. Design: A retrospective, cohort study Setting: Tertiary referral hospital Population: A total of 562 cycles were included in the study with 257 cycles of fresh ET and 305 cycles of FET in patients with adenomyosis. Methods: According to ovarian stimulation protocol in fresh ET and embryo origin in FET, ultra-long, long, short and antagonist subgroups were divided. Main Outcomes Measure(s)：clinical pregnancy rate (CPR), implantation rate(IR), miscarriage rate (MR) and live birth rate (LBR). Results：Compared with ultra-long and long protocols, IR (28.2% versus 49.7%, 52.1%, P=0.001) and CPR (35.6% versus 64.3%, 57.4%, P=0.004) in short protocol significantly decreased. Similarly, a decreased inclination of IR (33.3% versus 49.7%, 52.1%) and CPR (38.2% versus 57.4%, 64.3%) existed in antagonist protocol, although no statistical significance was detected because of strict P adjustment of Bonferroni method (Padj=0.008). Compared with long protocol, LBR in short protocol decreased obviously (48.2% versus 20.3%, P<0.001). LBR in antagonist protocol was also similarly poor (39.8% versus 26.5% and 20.3%). In FET cycles, no matter which origin of embryo, IR, CPR and LBR had no statistical difference. Conclusions：In fresh ET cycles, ultra-long or long protocol could be appropriate choices. whole embryo frozen combined with FET might recover the poor outcomes of antagonist and short protocols in fresh ET. embryo origin had no impact on pregnancy outcomes in FET cycles.

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Section: Characteristics Of Antagonist Protocol In Fresh Et Cycles An...supporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Effects of different ovarian stimulation protocols on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with adenomyosis: a retrospective cohort study

Ge¹,

Cui

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Wu et al found that FET following long-term GnRH agonist pretreatment had a higher live birth rate than fresh embryo transfer with a long or ultra-long GnRH agonist protocol [ 26 ]. Another study showed that vitrified-warmed embryo transfer achieved a higher singleton live birth rate and lower risk of preterm birth than fresh embryo transfer in women with adenomyosis [ 19 ], however, this study did not compare different COH protocols.…”

Section: Discussionmentioning

confidence: 99%

Comparison of pregnancy outcomes between GnRH antagonist protocol with freeze-all strategy and long-acting GnRH agonist protocol in women with adenomyosis undergoing IVF/ICSI: a propensity-score matching analysis

Zhang

Cai

Liu

et al. 2022

BMC Pregnancy Childbirth

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Background Plenty of studies explored the most optimal treatment protocol for infertile women with adenomyosis in in-vitro fertilization (IVF) /intracytoplasmic sperm injection (ICSI), however, there is still no consensus on which treatment protocol is ideal for these women at present. So, we conducted this study comparing the pregnancy outcomes in infertile women with ultrasound-diagnosed adenomyosis who underwent GnRH antagonist protocol with freeze-all strategy or long-acting GnRH agonist protocol. Methods This was a retrospective cohort study and a propensity-score matching (PSM) analysis including 282 women diagnosed with adenomyosis undergoing their first IVF/ICSI cycle from January 2016 to July 2021 at the Assisted Reproduction Center, Northwest Women’s and Children’s Hospital, China. The patients were divided into two groups: the GnRH antagonist protocol with freeze-all strategy (n = 168) and the long-acting GnRH agonist protocol with fresh embryo transfer (n = 114) according their treatment protocols. The primary outcome was live birth rate. Cumulative live birth rate was also calculated. Results After adjusting for confounders, clinical pregnancy rate (49.40% vs 64.04%; odds ratio (OR) 1.33; 95% confidence interval (CI) 0.70 to 2.37; P = 0.358), live birth rate (36.90% vs 45.61%; OR 1.10; 95% CI 0.61 to 2.00, P = 0.753) and cumulative live birth rate (51.79% vs 64.04%; OR 1.01; 95% CI 0.49 to 1.74, P = 0.796) were not significantly different between the GnRH antagonist protocol with freeze-all strategy and long-acting GnRH agonist protocol. Similar results were conducted in PSM analysis with clinical pregnancy rate (46.48% vs 60.56%; OR 1.33; 95% CI 0.76 to 2.34; P = 0.321), live birth rate (32.39% vs 45.07%; OR 1.31; 95% CI 0.63 to 2.72, P = 0.463) and cumulative live birth rate (54.90% vs 60.60%; OR 1.01; 95% CI 0.59 to 1.74, P = 0.958). Conclusions For infertile women with adenomyosis, these two treatment protocols resulted in similar pregnancy outcomes. Larger, prospective studies are needed in the future.

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“…In a similar retrospective cohort, an ultra-long GnRH agonist protocol compared with a long agonist protocol was also associated with increased live birth rate and clinical pregnancy rate with fresh transfer [32 ▪ ]. The impact of GnRH-agonist pretreatment on live birth rate and clinical pregnancy rate may be different for fresh and frozen cycles [33 ▪ ].…”

Section: Treatment Of Adenomyosis For Patients With Infertilitymentioning

confidence: 91%

Adenomyosis and fertility: does adenomyosis impact fertility and does treatment improve outcomes

French

Zhang

Movilla

et al. 2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewAdenomyosis has recently been associated with infertility. Relief of bleeding and pain has been demonstrated with medical and surgical therapy. Less is known about reproductive outcomes after treatment. Recent findingsImaging findings during infertility evaluation can be suggestive of adenomyosis without pathologic evaluation. Among women with infertility undergoing assisted reproductive technologies (ART), adenomyosis is associated with lower live birth rates and clinical pregnancy rates. Treatment with gonadotropin releasing hormone (GnRH) modulators prior to frozen embryo transfer may increase the live birth rate and clinical pregnancy rate among women with adenomyosis. Pregnancy has been documented following image-guided adenomyosis ablation; however, the reproductive impact is not well established. Pregnancy following excisional procedures appears to be well tolerated, although may carry a higher risk of uterine rupture compared with pregnancy following myomectomy. It is not clear if ablative therapy or resection increases pregnancy rates. SummaryAdenomyosis is associated with lower embryo implantation rates and ongoing pregnancy rates. Adenomyotic changes in the uterus can be seen by ultrasound and MRI. GnRH modulators may be useful for women with adenomyosis undergoing ART. Additional prospective data is warranted to determine the optimal medical or surgical therapy for women with adenomyosis desiring conception.

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Long-term GnRH agonist pretreatment before frozen embryo transfer improves pregnancy outcomes in women with adenomyosis

Cited by 19 publications

References 49 publications

Effects of different ovarian stimulation protocols on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with adenomyosis: a retrospective cohort study

Effects of different ovarian stimulation protocols on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with adenomyosis: a retrospective cohort study

Comparison of pregnancy outcomes between GnRH antagonist protocol with freeze-all strategy and long-acting GnRH agonist protocol in women with adenomyosis undergoing IVF/ICSI: a propensity-score matching analysis

Adenomyosis and fertility: does adenomyosis impact fertility and does treatment improve outcomes

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