The Impact of MRI-Confirmed Diagnosis of Adenomyosis on the Success of Infertility Treatment

Wold, Anne; Patrizio, Pasquale; Sepúlveda, José; Edusa, A.; Arıcı, Aydın

doi:10.1016/j.fertnstert.2005.07.482

Cited by 4 publications

(5 citation statements)

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“…a daily dose of a GnRH agonist [32]. In some published clinical reports [7][8][9]11], adenomyosis had a detrimental effect on IVF outcome in terms of pregnancy or live birth rate, indicating impaired endometrial receptivity. In the study of Fischer et al [33], expression of the HOXA10 gene, an established marker of endometrial receptivity, was shown to be decreased in the secretory phase in the endometrium of women with adenomyosis.…”

Section: Discussionmentioning

confidence: 99%

“…The effect of adenomyosis on the outcome of in vitro fertilization (IVF)/intracytoplasmic sperm (ICSI) is unclear, due to a limited number of small observational studies reporting either no effect or a poorer outcome in the presence of this disease [6][7][8][9][10][11]. Several case studies have reported successful pregnancies and live births following gonadotropin-releasing hormone (GnRH) agonist treatment for adenomyosis and infertility [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis

Niu

Chen

Sun

et al. 2013

Gynecological Endocrinology

138

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Some studies have shown that long-term gonadotropin-releasing hormone (GnRH) agonist administration before in vitro fertilization/intracytoplasmic sperm in infertile women with endometriosis or adenomyosis significantly increases the chances of pregnancy. We were interested in whether long-term GnRH agonist pretreatment could improve pregnancy outcomes in adenomyosis patients undergoing frozen embryo transfer (FET) after preparation of the endometrium with hormone replacement therapy (HRT). Totally, 339 patients with adenomyosis were included in this retrospective study, 194 received long-term GnRH agonist plus HRT (down-regulation + HRT) and 145 received HRT. There were no differences between the groups in characteristic such as age, body mass index, duration or cause of infertility, serum CA-125 level and basal hormone levels. On the day of progesterone administration, mean endometrial thickness and serum progesterone level were significantly greater in HRT patients. Mean score and number of embryos transferred showed no differences. In down regulation + HRT group, clinical pregnancy, implantation and ongoing pregnancy rates were 51.35%, 32.56% and 48.91%, respectively, significantly higher than that of HRT group (24.83%, 16.07% and 21.38%, respectively). So, we concluded that in FET, long-term GnRH agonist pretreatment significantly improved pregnancy outcomes in patients with adenomyosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis

Niu

Chen

Sun

et al. 2013

Gynecological Endocrinology

138

View full text Add to dashboard Cite

show abstract

“…2 To date, the effect of adenomyosis on in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment outcome is unclear due to only a limited number of small observational studies reporting either no effect or a poorer outcome associated with the presence of adenomyosis. [3][4][5] It has been postulated that the presence of abnormal vascularity and heterotopic glands in the myometrium of patients with adenomyosis may be a source of cytokines and immunological factors that can have a negative impact on endometrial receptivity and placentation. 6 There is also accumulating evidence that shows that adenomyosis has an effect on endometrial cell antigen expression, cytokine production, and production of oxygen-free radicals, all of which are suggestive of the disruption of endometrial receptivity.…”

Section: Introductionmentioning

confidence: 99%

Cytokine Profiling in the Eutopic Endometrium of Adenomyosis During the Implantation Window After Ovarian Stimulation

et al. 2016

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In this study, we aimed to clarify the inflammatory cytokine profile of endometrium in patients with adenomyosis during the implantation window after ovarian stimulation. Eighteen patients with adenomyosis and 24 control patients undergoing in vitro fertilization treatment were included in this prospective case-control study. Regular gonadotropin-releasing hormone antagonist protocol was used for ovarian stimulation. Endometrial samples were obtained 7 days after human chorionic gonadotropin (hCG) injection (hCG + 7). Cytokine levels in endometrium secretions from women with and without adenomyosis were assayed by multiplex immunoassay, levels of interleukin (IL) 6 (25.9 ± 6.6 vs 12.4 ± 3.4 pg/mL; P = .001), IL-10 (10.4 ± 2.9 vs 15.6 ± 4.2 pg/mL; P = .001), IL-17 (11.9 ± 3.0 vs 14.2 ± 3.9 pg/mL; P = .046), interferon-γ (11.7 ± 3.5 vs 8.0 ± 3.4 pg/mL; P = .001), and monocyte chemoattractant protein-1 (MCP-1; 37.1 ± 6.5 vs 16.4 ± 3.2 pg/mL; P = .001) were significantly different between patients with adenomyosis and control groups, respectively. Immunohistochemistry and quantitative real-time polymerase chain reaction showed that CD-68+, IL-6, and MCP-1 expression were higher and IL-10 was lower in adenomyosis endometrium epithelia compared to controls. In conclusion, within the implantation window of ovarian stimulation cycles, macrophages, IL-6, IL-10, and MCP-1 are expressed differently in the endometrium of women with adenomyosis, which may correlate with compromised endometrium receptivity. We postulated that cytokines of endometrial secretions expressed differently in patients with adenomyosis may contribute to impaired endometrium receptivity in these patients.

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“…Considerando-se também a freqüente concomitância de endometriose e fator tubo-peritoneal em que é necessária a aplicação da FIV para obtenção de gestação, a implantação dos embriões poderia estar prejudicada, naquelas com adenomiose associada 9 , pela disperistalse uterina, diminuindo assim as taxas de gestação obtidas pelo método. Embora alguns autores mostrem não haver diferenças nas taxas de gestação entre mulheres com e sem endometriose pela FIV 20 , outros trabalhos apontam redução destas taxas na presença de adenomiose 9,21,22 , relacionando diretamente os resultados com a espessura da ZJ à RMP 23 . Quando a média da espessura da ZJ é inferior a 7 mm, a taxa de gravidez chega a 62%, contra 5% encontrada entre aquelas com ZJ superior a 10 mm 23 .…”

Section: Discussionunclassified

“…Quanto a sua etiologia, estudos têm sustentado a hipótese de que o endométrio tópico das portadoras de adenomiose apresenta aumento da atividade da aromatase P450, que promoveria maior capacidade de produção estrogênica local, determinando maior potencial de crescimento e invasão para o interior do miométrio 5,[7][8][9] .…”

Section: Introductionunclassified

Aplicação de dispositivo intra-uterino liberador de levonorgestrel, previamente a ciclos de fertilização in vitro, nas portadoras de adenomiose

Donadio¹,

Dotore²,

Silva³

et al. 2006

Rev. Bras. Ginecol. Obstet.

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Objetivo: verifi car os efeitos do dispositivo intra-uterino (DIU) de levonorgestrel em portadoras de adenomiose, com falhas de implantação em ciclos de fertilização in vitro (FIV). Métodos: foram selecionadas 80 mulheres inférteis, com até 38 anos, com diagnóstico de adenomiose pela ultra-sonografi a e ressonância magnética pélvica. Todas apresentavam tentativas anteriores de FIV sem sucesso. No grupo Diu, de 40 mulheres, foi colocado DIU liberador de 20 µg de levonorgestrel/dia por seis meses, previamente a um novo ciclo de FIV. No grupo Fiv, de 40 mulheres, estas foram submetidas diretamente a novo ciclo, sem o prévio tratamento. No Grupo Diu, avaliaram-se o volume uterino, a espessura e os focos de hipersinal da zona juncional, pré e pós-tratamento, assim como as taxas de gravidez em novo ciclo de FIV comparadas com as obtidas no grupo Fiv. As análises estatísticas foram realizadas adotando-se o nível de signifi cância de 5% (p<0,05), sendo aplicados os testes t de Student e Mann-Whitney. Resultados: após o tratamento, verifi cou-se redução em 77,7% dos casos de adenomiose focal, além de redução considerada signifi cativa do volume uterino e da espessura média da zona juncional de 128,8 para 93,6 mL e de 12,3 para 11,3 mm, respectivamente. No grupo Diu, a taxa de gravidez atingiu 30%, valor superior, embora não de forma signifi cativa, ao encontrado no grupo Fiv, de 17,5%. Conclusão: o uso do DIU com levonorgestrel pode ser indicado previamente a ciclos de FIV em pacientes portadoras de adenomiose, com falhas de implantação anteriores.

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The Impact of MRI-Confirmed Diagnosis of Adenomyosis on the Success of Infertility Treatment

Cited by 4 publications

References 0 publications

Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis

Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis

Cytokine Profiling in the Eutopic Endometrium of Adenomyosis During the Implantation Window After Ovarian Stimulation

Aplicação de dispositivo intra-uterino liberador de levonorgestrel, previamente a ciclos de fertilização in vitro, nas portadoras de adenomiose

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