Cargando…

Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study

(1) Background: The presence of adenomyosis among pregnant patients has been associated with a higher incidence of miscarriage and pregnancy complications. Although the role of adenomyosis in women undergoing in vitro fertilization (IVF) was investigated in several studies and demonstrated a potenti...

Descripción completa

Detalles Bibliográficos
Autores principales: Sachs-Guedj, Noémie, Coroleu, Buenaventura, Pascual, María Ángela, Rodríguez, Ignacio, Polyzos, Nikolaos P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531755/
https://www.ncbi.nlm.nih.gov/pubmed/37762998
http://dx.doi.org/10.3390/jcm12186058
_version_ 1785111794484772864
author Sachs-Guedj, Noémie
Coroleu, Buenaventura
Pascual, María Ángela
Rodríguez, Ignacio
Polyzos, Nikolaos P.
author_facet Sachs-Guedj, Noémie
Coroleu, Buenaventura
Pascual, María Ángela
Rodríguez, Ignacio
Polyzos, Nikolaos P.
author_sort Sachs-Guedj, Noémie
collection PubMed
description (1) Background: The presence of adenomyosis among pregnant patients has been associated with a higher incidence of miscarriage and pregnancy complications. Although the role of adenomyosis in women undergoing in vitro fertilization (IVF) was investigated in several studies and demonstrated a potentially detrimental effect on live birth rates following IVF, most of them were small studies in which the adenomyosis diagnosis was not confirmed based on solid ultrasonographic criteria. (2) Methods: 3503 patients undergoing their first blastocyst frozen transfer through a hormonal replacement (HRT) FET cycle. Among them, 140 women had a confirmed diagnosis of adenomyosis based on the MUSA criteria. (3) Results: Adenomyosis patients were more likely to proceed with deferred FET compared with no-adenomyosis women (p = 0.002) and were significantly more likely to be treated with GnRH agonist pre-treatment (2 months) (p < 0.001). The presence of adenomyosis significantly decreased the clinical pregnancy rates (aOR 0.62, 95% CI: 0.39–0.98, p = 0.040) and live birth rates (aOR 0.46, 95% CI: 0.27–0.75, p = 0.003) and significantly increased the miscarriage rates (aOR 2.13, 95% CI: 0.98–4.37, p = 0.045). Multivariable logistic regression adjusting for age, autologous or donor oocytes, PGT-A, deferred FET, serum progesterone levels the day before FET, GnRH agonist pre-treatment, number of embryos transferred, and adenomyosis demonstrated that the use of the GnRH agonist protocol did not decrease or increase the miscarriage rate, clinical pregnancy rate, or live birth rate. (4) Conclusions: The presence of adenomyosis had a significant negative impact on the clinical outcomes of patients undergoing FET and was associated with higher miscarriage, lower clinical pregnancy, and live birth rates. GnRH agonist pre-treatment does not appear to improve clinical outcomes.
format Online
Article
Text
id pubmed-10531755
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-105317552023-09-28 Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study Sachs-Guedj, Noémie Coroleu, Buenaventura Pascual, María Ángela Rodríguez, Ignacio Polyzos, Nikolaos P. J Clin Med Article (1) Background: The presence of adenomyosis among pregnant patients has been associated with a higher incidence of miscarriage and pregnancy complications. Although the role of adenomyosis in women undergoing in vitro fertilization (IVF) was investigated in several studies and demonstrated a potentially detrimental effect on live birth rates following IVF, most of them were small studies in which the adenomyosis diagnosis was not confirmed based on solid ultrasonographic criteria. (2) Methods: 3503 patients undergoing their first blastocyst frozen transfer through a hormonal replacement (HRT) FET cycle. Among them, 140 women had a confirmed diagnosis of adenomyosis based on the MUSA criteria. (3) Results: Adenomyosis patients were more likely to proceed with deferred FET compared with no-adenomyosis women (p = 0.002) and were significantly more likely to be treated with GnRH agonist pre-treatment (2 months) (p < 0.001). The presence of adenomyosis significantly decreased the clinical pregnancy rates (aOR 0.62, 95% CI: 0.39–0.98, p = 0.040) and live birth rates (aOR 0.46, 95% CI: 0.27–0.75, p = 0.003) and significantly increased the miscarriage rates (aOR 2.13, 95% CI: 0.98–4.37, p = 0.045). Multivariable logistic regression adjusting for age, autologous or donor oocytes, PGT-A, deferred FET, serum progesterone levels the day before FET, GnRH agonist pre-treatment, number of embryos transferred, and adenomyosis demonstrated that the use of the GnRH agonist protocol did not decrease or increase the miscarriage rate, clinical pregnancy rate, or live birth rate. (4) Conclusions: The presence of adenomyosis had a significant negative impact on the clinical outcomes of patients undergoing FET and was associated with higher miscarriage, lower clinical pregnancy, and live birth rates. GnRH agonist pre-treatment does not appear to improve clinical outcomes. MDPI 2023-09-19 /pmc/articles/PMC10531755/ /pubmed/37762998 http://dx.doi.org/10.3390/jcm12186058 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Sachs-Guedj, Noémie
Coroleu, Buenaventura
Pascual, María Ángela
Rodríguez, Ignacio
Polyzos, Nikolaos P.
Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study
title Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study
title_full Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study
title_fullStr Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study
title_full_unstemmed Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study
title_short Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study
title_sort presence of adenomyosis impairs clinical outcomes in women undergoing frozen embryo transfer: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10531755/
https://www.ncbi.nlm.nih.gov/pubmed/37762998
http://dx.doi.org/10.3390/jcm12186058
work_keys_str_mv AT sachsguedjnoemie presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy
AT coroleubuenaventura presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy
AT pascualmariaangela presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy
AT rodriguezignacio presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy
AT polyzosnikolaosp presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy