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Clinical outcomes after single-versus double-embryo transfers in women with adenomyosis: a retrospective study

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Adenomyosis affects the outcomes of spontaneous fertility and assisted reproductive technology. The single blastocyst embryo transfer (SBT) policy is an effective strategy known to minimize the risk of multiple pregnancy for non-adenomyosis women. However, little is known about its applicability to women with adenomyosis. The purpose of this study is to compare pregnancy outcomes between SBT, double-blastocyst embryo transfer (DBT), single-cleavage-stage embryo transfer (SET) and double-cleavage-stage embryo transfer (DET) in the frozen–thawed embryo transfer cycles among adenomyosis patients.

Methods

This retrospective study was conducted in all frozen–thawed autologous embryo transfer cycles. 393 frozen–thawed embryo transfer cycles performed in adenomyosis patients were enrolled. The major clinical outcomes were implantation rate (IR), clinical pregnancy rate (CPR), miscarriage rate (MR), multiple pregnancy rate (MPR) and live birth rate (LBR).

Results

 The SBT and DBT groups achieved higher IR (P < 0.001), CPR (P = 0.017), LBR (P = 0.040) and lower MR (P = 0.020) than the SET and DET groups. But the SBT and DBT groups achieved similar CPR and LBR. The SBT and SET groups achieved lower MPR (P < 0.001) than the DBT and DET groups. The average birth weight (BW) of SBT groups was higher than the DBT and DET groups (P = 0.016). When compared with SBT group, low-birth-weight infants were significantly higher with DBT and DET.

Conclusions

When performing frozen–thawed embryo transfer cycles among adenomyosis patients, the SBT group has similar IR, CPR, MR, LBR but lower MPR compared to the DBT group. Therefore, SBT might be offered as standard practice.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AMH:

Anti-Mullerian hormone

ASRM:

The American Society for Reproductive Medicine

BMI:

Body mass index

BPR:

Biochemical pregnancy rate

BW:

Birth weight

COH:

Controlled ovarian hyperstimulation

COS:

Controlled ovarian stimulation

CPR:

Clinical pregnancy rate

DBT:

Double-blastocyst embryo transfer

DET:

Double-cleavage-stage embryo transfer

eNOS:

Endothelial nitric oxide synthase

GnRH-a:

Gonadotropin-releasing hormone agonist

hCG:

Human chorionic gonadotropin

HRT:

Hormone replacement treatment

ICIS:

Intracytoplasmic sperm injection

IR:

Implantation rate

IVF:

In vitro fertilization

LBR:

Live birth rate

MPR:

Multiple pregnancy rate

MR:

Miscarriage rate

PBR:

Preterm birth rate

SBT:

Single-blastocyst embryo transfer

SET:

Single-cleavage-stage embryo transfer

VEGF:

Vascular endothelial growth factor

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Acknowledgements

Not applicable.

Funding

This work was supported by the Science and Technology Program of Guangdong Province (2014A020213002) and the Free Application Project of Guangdong Natural Science Foundation (2015A030313131).

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Author notes

  1. Jiayi Guo and Zhi Zeng contributed equally to this work.

Authors and Affiliations

  1. Reproductive Medicine Center, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510655, China

    Jiayi Guo, Zhi Zeng, Manchao Li, Jiana Huang, Jintao Peng, Meng Wang, Xiaoyan Liang & Haitao Zeng

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  1. Jiayi Guo
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  2. Zhi Zeng
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  3. Manchao Li
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Contributions

JG and ZZ designed the study. ML and JH were responsible for the data collection and checking. JG performed the data analysis and manuscript drafting. JP, MW and XL dealt with data visualization. HZ supervised the project administration.

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Correspondence to Haitao Zeng.

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The authors have no conflicts of interest to declare.

Ethics approval

This study was approved by the ethics committee of the Sixth Affiliated Hospital of Sun Yat-sen University.

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The requirement of informed consent was waived by the ethics committee because of the retrospective nature of the study.

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Guo, J., Zeng, Z., Li, M. et al. Clinical outcomes after single-versus double-embryo transfers in women with adenomyosis: a retrospective study. Arch Gynecol Obstet 304, 263–270 (2021). https://doi.org/10.1007/s00404-020-05924-5

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