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...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-09-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/18/6058 |
| _version_ | 1797579448741003264 |
|---|---|
| author | Noémie Sachs-Guedj Buenaventura Coroleu María Ángela Pascual Ignacio Rodríguez Nikolaos P. Polyzos |
| author_facet | Noémie Sachs-Guedj Buenaventura Coroleu María Ángela Pascual Ignacio Rodríguez Nikolaos P. Polyzos |
| author_sort | Noémie Sachs-Guedj |
| collection | DOAJ |
| 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 (<i>p</i> = 0.002) and were significantly more likely to be treated with GnRH agonist pre-treatment (2 months) (<i>p</i> < 0.001). The presence of adenomyosis significantly decreased the clinical pregnancy rates (aOR 0.62, 95% CI: 0.39–0.98, <i>p</i> = 0.040) and live birth rates (aOR 0.46, 95% CI: 0.27–0.75, <i>p</i> = 0.003) and significantly increased the miscarriage rates (aOR 2.13, 95% CI: 0.98–4.37, <i>p</i> = 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. |
| first_indexed | 2024-03-10T22:37:21Z |
| format | Article |
| id | doaj.art-93a7fce4ce1c451aa86839ca666c9e92 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T22:37:21Z |
| publishDate | 2023-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-93a7fce4ce1c451aa86839ca666c9e922023-11-19T11:21:12ZengMDPI AGJournal of Clinical Medicine2077-03832023-09-011218605810.3390/jcm12186058Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort StudyNoémie Sachs-Guedj0Buenaventura Coroleu1María Ángela Pascual2Ignacio Rodríguez3Nikolaos P. Polyzos4Department of Obstetrics, Gynecology and Reproduction, Dexeus University Hospital, 08028 Barcelona, SpainDepartment of Obstetrics, Gynecology and Reproduction, Dexeus University Hospital, 08028 Barcelona, SpainDepartment of Obstetrics, Gynecology and Reproduction, Dexeus University Hospital, 08028 Barcelona, SpainDepartment of Obstetrics, Gynecology and Reproduction, Dexeus University Hospital, 08028 Barcelona, SpainDepartment of Obstetrics, Gynecology and Reproduction, Dexeus University Hospital, 08028 Barcelona, Spain(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 (<i>p</i> = 0.002) and were significantly more likely to be treated with GnRH agonist pre-treatment (2 months) (<i>p</i> < 0.001). The presence of adenomyosis significantly decreased the clinical pregnancy rates (aOR 0.62, 95% CI: 0.39–0.98, <i>p</i> = 0.040) and live birth rates (aOR 0.46, 95% CI: 0.27–0.75, <i>p</i> = 0.003) and significantly increased the miscarriage rates (aOR 2.13, 95% CI: 0.98–4.37, <i>p</i> = 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.https://www.mdpi.com/2077-0383/12/18/6058adenomyosisfrozen embryo transferGnRH agonistMUSA criteria |
| spellingShingle | Noémie Sachs-Guedj Buenaventura Coroleu María Ángela Pascual Ignacio Rodríguez Nikolaos P. Polyzos Presence of Adenomyosis Impairs Clinical Outcomes in Women Undergoing Frozen Embryo Transfer: A Retrospective Cohort Study Journal of Clinical Medicine adenomyosis frozen embryo transfer GnRH agonist MUSA criteria |
| 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 | adenomyosis frozen embryo transfer GnRH agonist MUSA criteria |
| url | https://www.mdpi.com/2077-0383/12/18/6058 |
| work_keys_str_mv | AT noemiesachsguedj presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy AT buenaventuracoroleu presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy AT mariaangelapascual presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy AT ignaciorodriguez presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy AT nikolaosppolyzos presenceofadenomyosisimpairsclinicaloutcomesinwomenundergoingfrozenembryotransferaretrospectivecohortstudy |