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Does Adenomyosis Influence ICSI Clinical Outcome? A Systematic Analysis and Impact of GnRH Agonist Pretreatment for Women with Adenomyosis in ICSI–FET Cycle: A Retrospective Cohort Study



To evaluate the impact of adenomyosis on pregnancy outcome in ICSI/FET cycles and the beneficial effect of GnRH agonist pretreatment, conservative surgery or combination therapy on pregnancy outcome.

Materials and Methods

This is a retrospective cohort study where 613 ICSI cycles done in the period from Jan 2018 to Dec 2020 in Sudha infertility centre, Erode were analyzed. Study populations include 235 women with adenomyosis undergoing ICSI/FET cycle.


Overall, the outcome in terms of clinical pregnancy rate, miscarriage rate, live birth date and ongoing pregnancy rate was lower in women with adenomyosis following ICSI/FET cycles. We found significant improvement in clinical pregnancy rate who had pretreatment with GnRH agonist, conservative surgery or combination therapy.


Adenomyosis as such has detrimental effect on ICSI clinical outcome. Pretreatment with GnRH agonist and conservative surgery and GnRH agonist long protocol could be beneficial. Further large scale prospective comparative studies are needed to confirm this result.

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Correspondence to Pradeepa Sudhakar.

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Hereby, I Dr Pradeepa Sudhakar consciously assure that the for the manuscript submitted above where in accordance with the ethical standards and informed consent was obtained from all the patients being included in the study, Prior ethical approval was obtained from the Sudha Hospital Ethical Committee.

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Informed consent was obtained from all the patients for being included in the study.

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Pradeepa Sudhakar is a Senior Consultant IVF and Reproductive Medicine, Department of Obstetrics and Gynecology, Sudha Hospital, Erode, Tamil Nadu, India; Saranya Manivannan is a Consultant IVF and Reproductive Medicine, Department of Obstetrics and Gynecology, Sudha Hospital, Erode, Tamil Nadu, India; Dhanabagyam Kandasamy is a Director, Department of Reproductive Medicine, Sudha Hospital, Coimbatore, Tamil Nadu, India.

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Sudhakar, P., Manivannan, S., Kandasamy, D. et al. Does Adenomyosis Influence ICSI Clinical Outcome? A Systematic Analysis and Impact of GnRH Agonist Pretreatment for Women with Adenomyosis in ICSI–FET Cycle: A Retrospective Cohort Study. J Obstet Gynecol India 72, 236–242 (2022).

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  • Adenomyosis
  • Pregnancy outcome
  • Systematic analysis
  • ICSI-FET cycles