Effect of Adenomyosis on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Infertile Women: A Retrospective Cohort Study

Yan, Lei; Ding, Lingling; Tang, Rong; Chen, Zi‐Jiang

doi:10.1159/000355101

Cited by 34 publications

(65 citation statements)

References 15 publications

(18 reference statements)

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“…Also, our findings emphasize the importance of using combined treatment for infertility patients affected by endometriosis of different stages and in the case of coexisting adenomyosis. In contrast, there is evidence that adenomyosis has a negative impact on the pregnancy outcome [34]. However, the results of our study suggested that the pregnancy rate was not affected by the higher frequency of adenomyosis in the patients with more severe stages of endometriosis compared to the patients with minimal to mild endometriosis.…”

Section: Discussioncontrasting

confidence: 89%

Pregnancy Rate in Endometriosis Patients according to the Severity of the Disease after Using a Combined Approach of Laparoscopy, GnRH Agonist Treatment and in vitro Fertilization

Sõritsa

Saare²,

Laisk³

et al. 2014

Gynecol Obstet Invest

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Aim: To evaluate the effects of combined treatment approaches on endometriosis-associated infertility in different stages of endometriosis using laparoscopy, gonadotropin-releasing hormone (GnRH) agonist (GnRHa) therapy and in vitro fertilization (IVF). Methods: This retrospective study was carried out on 179 women with surgically confirmed endometriosis. Patients were divided into subgroups: group 1 (stage I-II, n = 121) and group 2 (stage III-IV, n = 58). Patients eligible for IVF, who were found to have adenomyosis or moderate to severe endometriosis, were also given postoperative GnRHa. Pregnancy and delivery rates were cumulatively calculated during 5 years according to the severity of the disease. Results: The overall pregnancy, delivery and miscarriage rates were 66.5, 56.4 and 15.1%, respectively, for all patients following spontaneous and assisted conception. There were no significant differences in reproductive outcomes between the study groups. The pregnancy and delivery rates were also comparable within group 1 between the patients with and without GnRHa treatment. Conclusion: Pregnancy and delivery rates at different stages of endometriosis were not affected by the different approaches used for infertility treatment, with >60 and >50% of patients having conceived and delivered a baby, respectively, in both groups. The usefulness of GnRHa treatment for endometriosis patients with minimal to mild forms is questionable and deserves further studies.

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Section: Discussioncontrasting

confidence: 89%

Pregnancy Rate in Endometriosis Patients according to the Severity of the Disease after Using a Combined Approach of Laparoscopy, GnRH Agonist Treatment and in vitro Fertilization

Sõritsa

Saare²,

Laisk³

et al. 2014

Gynecol Obstet Invest

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“…Diagnostic criteria for AD were based on MRI findings of abnormal myometrial and JZ thickness in two IVF studies: Ballester, 2012 ; Maubon, 2010 . TVS in nine IVF / ICSI studies: Costello, 2011 ; Chiang, 1999 ; Martinez‐Conejero, 2011 ; Mijatovic, 2010 ; Salim, 2012 ; Thalluri, 2012 ; Youm, 2011 ; Yan, 2014 ; Benaglia, 2014 . In studies of women scheduled for endometriosis surgery, diagnosis was based on MRI in one study: Landi 2008 , TVS in two: Stepniewska, 2010 ; Soriano, 2016 and both techniques in two: Darai, 2010 ; Ferrero, 2009 .…”

Section: Methodsmentioning

confidence: 99%

“…The effect of AD on IVF/intracytoplasmic sperm injection (ICSI) outcome has been described in a total of 11 studies. Four studies were case–control studies , and seven cohort studies . Additionally, the effect of AD on pregnancy rate (PR) (both spontaneous and ART pregnancy) after surgery for rectovaginal and colorectal endometriosis is described in five trials .…”

Section: Effect Of Adenomyosis On Reproductive Outcomementioning

confidence: 99%

“…Selection bias could mask the effect of AD in two case–control studies using retrospectively identified cases and controls. One had lower PRs among women with AD , and another only included 19 women with AD and a large control group of 144 . Benaglia performed a prospective case–control study and only included 49 asymptomatic women with AD, comparing them with 49 matched controls.…”

Section: Effect Of Adenomyosis On Reproductive Outcomementioning

confidence: 99%

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Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery

Dueholm

2017

Acta Obstet Gynecol Scand

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This review includes an analysis of the clinical studies evaluating reproductive outcome and adenomyosis, and a review of studies on reproductive outcome and surgical treatment options for adenomyosis. Strict diagnostic criteria and classification of disease are needed for an image diagnosis of adenomyosis. Studies of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) populations and women with surgically treated deep endometriosis have suggested that adenomyosis has a negative impact on reproductive outcome, although there are substantial variations between studies. Few data are available on the relation between the extent of disease and impact on reproductive outcome, but a correlation appears to exist. Case series seem to confirm a positive effect of gonadotropin-releasing hormone analog treatment and surgery on reproductive outcome, but there are no controlled trials. Evidence is impaired by the poor quality of many studies, a lack of strict image diagnosis, and the absence of a classification of the extent of disease. Selection of the optimal evidence-based treatment options for adenomyosis in the fertility clinic is difficult because of a lack of evidence regarding the relation between fertility and the degree and composition of adenomyosis. Adenomyosis may reduce implantation so severely that surgical or other treatment options should be recommended, but the benefit of these treatment options needs to be verified. Referral of women with adenomyosis and recurrent miscarriage and repeated failure of assisted reproductive technology to centers with a special interest in adenomyosis research and treatment may be critical.

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“…The ultrasound examination was done by the same ultrasonographer, using the same ultrasound equipment (Hitachi EUB-2000, Japan). The serum FSH, luteinizing hormone and E 2 levels were determined by the electrochemiluminescence immunoassay (Roche, Basel, Switzerland) on day 4 of the menses for all treated women [20]. Information about sperm concentration, sperm motility and sperm morphological features of the partners was also recorded (WLJY-9000 semen analyzer, China).…”

Section: Methodsmentioning

confidence: 99%

A Comparison of the Efficacy of Two Doses of Letrozole Alone or with Continuous Recombinant Follicle-Stimulating Hormone for Ovulation Induction in Anovulatory Women

Wang

Zheng²

2014

Gynecol Obstet Invest

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Aims: To determine the efficacy of letrozole alone or with recombinant follicle-stimulating hormone (rFSH) for ovarian induction in anovulatory women. Methods: A total of 322 patients undergoing intrauterine insemination (IUI) were included in this retrospective study. Letrozole (2.5 or 5.0 mg) was administered from days 5 to 9 of menses, alone or followed with rFSH started on day 9 until the day of human chorionic gonadotropin administration. A single IUI was performed 24 h after ovulation. Results: The number of follicles, endometrial thickness and serum estradiol levels were significantly higher in the letrozole + rFSH groups than in the letrozole-alone groups (p < 0.05), but no significant difference was found between the two doses of letrozole, whether alone or with rFSH. Women treated with 5.0 mg/day of letrozole + rFSH required a total dose of rFSH similar to women treated with 2.5 mg/day of letrozole + rFSH (230.77 ± 118.29 vs. 258.55 ± 130.13 IU, respectively; p = 0.205). There was no significant difference in pregnancy rates between the two doses of letrozole, whether alone or with rFSH. Conclusion: Treatment with letrozole + rFSH was more efficacious than letrozole alone for pregnancy in the IUI program; however, the effect of 5.0 mg/day of letrozole versus 2.5 mg/day of letrozole on ovulation was equivalent, regardless of whether rFSH was used.

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Effect of Adenomyosis on In Vitro Fertilization/Intracytoplasmic Sperm Injection Outcomes in Infertile Women: A Retrospective Cohort Study

Cited by 34 publications

References 15 publications

Pregnancy Rate in Endometriosis Patients according to the Severity of the Disease after Using a Combined Approach of Laparoscopy, GnRH Agonist Treatment and in vitro Fertilization

Pregnancy Rate in Endometriosis Patients according to the Severity of the Disease after Using a Combined Approach of Laparoscopy, GnRH Agonist Treatment and in vitro Fertilization

Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery

A Comparison of the Efficacy of Two Doses of Letrozole Alone or with Continuous Recombinant Follicle-Stimulating Hormone for Ovulation Induction in Anovulatory Women

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