The effect of adenomyosis on IVF after long or ultra-long GnRH agonist treatment
| Autor: | Huizhi Shan, Jun Xing, Xiaoni Hou, Jie Mei, Guijun Yan, Junxia Wang, Yanxin Sun, Haixiang Sun |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine Agonist Infertility endocrine system medicine.medical_specialty medicine.drug_class Fertilization in Vitro Gonadotropin-releasing hormone Miscarriage 03 medical and health sciences 0302 clinical medicine Ovulation Induction Pregnancy medicine Humans Adenomyosis Ovarian Reserve Ovarian reserve Gynecology Triptorelin Pamoate 030219 obstetrics & reproductive medicine business.industry Pregnancy Outcome Obstetrics and Gynecology medicine.disease Luteolytic Agents 030104 developmental biology Reproductive Medicine Female Follicle Stimulating Hormone business Live birth Infertility Female hormones hormone substitutes and hormone antagonists Developmental Biology |
| Zdroj: | Reproductive BioMedicine Online. 41:845-853 |
| ISSN: | 1472-6483 |
| DOI: | 10.1016/j.rbmo.2020.07.027 |
| Popis: | RESEARCH QUESTION Does adenomyosis affect IVF independent of decreased ovarian reserve, and what are the characteristics and IVF outcome of the ultra-long gonadotrophin-releasing hormone (GnRH) agonist protocol in adenomyosis? DESIGN Observational cohort study of three groups of patients undergoing first cycle of IVF treatment with normal ovarian reserve: (A) 362 patients with adenomyosis using the ultra-long GnRH agonist protocol; (B) 127 patients with adenomyosis using the long GnRH agonist protocol; (C) 3471 patients with tubal infertility using the long GnRH agonist protocol. RESULTS Compared with groups B and C, the number of oocytes retrieved in group A decreased, and the gonadotrophin dosage and duration in group A were higher (P < 0.001). In long GnRH agonist treatment, clinical pregnancy rate (OR 0.492, 95% CI 0.327 to 0.742, P < 0.001), implantation rate (OR 0.527, 95% CI 0.350 to 0.794, P = 0.002) and live birth rate (OR 0.442, 95% CI 0.291 to 0.673, P < 0.001) decreased and miscarriage rate (OR 3.078, 95% CI 1.593 to 5.948, P < 0.001) increased in adenomyosis patients compared with tubal infertility. For adenomyosis patients, clinical pregnancy rate (OR 1.925, 95% CI 1.137 to 3.250, P = 0.015), implantation rate (OR 1.694, 95% CI 1.006 to 2.854, P = 0.047) and live birth rate (OR 1.704, 95% CI 1.012 to 2.859, P = 0.044) increased in the ultra-long GnRH agonist treatment compared with long GnRH agonist treatments. CONCLUSION Adenomyosis could negatively affect IVF outcomes independent of ovarian reserve after long GnRH agonist protocol. Patients with adenomyosis following the ultra-long GnRH agonist protocol could have a better pregnancy outcome than those following the long GnRH agonist protocol. |
| Databáze: | OpenAIRE |
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