Long-term GnRH agonist pretreatment before frozen embryo transfer improves pregnancy outcomes in women with adenomyosis. Issue 2 (February 2022)

• Record Type: Journal Article
• Authors: Wu, Yingchen; Huang, Jianyun; Zhong, Guangzheng; Lan, Jie; Lin, Haiyan; Zhang, Qingxue
• Is Part Of: Reproductive biomedicine online. Volume 44:Issue 2(2022)
• Page Start: 380
• Page End: 388
• Publication Date: 2022-02
• Subjects: Adenomyosis -- Frozen embryo transfer -- GnRH agonist pretreatment -- IVF/ICSI -- Pregnancy outcomes; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2021.10.014
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: Do frozen embryo transfer (FET) cycles following long-term gonadotrophin-releasing hormone agonist (GnRHa) pretreatment have better pregnancy outcomes than fresh embryo transfer cycles with long or ultra-long GnRHa protocol in these patients? Design: This study included 537 women with adenomyosis divided into three groups: (Group A) FET cycles following long-term GnRHa pretreatment (192 patients); (Group B) fresh embryo transfer cycles with the ultra-long GnRHa protocol (241 patients); (Group C) fresh embryo transfer cycles with the long GnRHa protocol (104 patients). Results: The total gonadotrophin dose and stimulation duration were significantly lower in Group A than in Groups B and C. The implantation and live birth rates were significantly higher in Group A than in Groups B and C. In the long-term GnRHa pretreatment and FET treatment of Group A, implantation (odds ratio [OR] 1.729, 95% confidence interval [CI] 1.073–2.788, P = 0.025), clinical pregnancy (OR 1.665, 95% CI 1.032–2.686, P = 0.037) and live birth rates (OR 1.694, 95% CI 1.045–2.746, P = 0.033) increased and miscarriage rate (OR 0.203, 95% CI 0.078–0.530, P = 0.001) decreased when compared with Group C. Comparison of Groups A and B showed that with the long-term GnRHa pretreatment, FET was a protective factor for live birth rate (OR 1.350, 95% CI 1.017–1.792, P = 0.038). Conclusion: FET following long-term GnRHa pretreatment has a better IVF/intracytoplasmic sperm injection outcome, and a potential benefit in terms of a lower gonadotrophin dose, and a shorter stimulation duration than fresh embryo transfer combined with a long or ultra-long GnRHa protocol.