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Pregnancy outcomes of infertile women with ultrasound-diagnosed adenomyosis for in vitro fertilization and frozen–thawed embryo transfer

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

Abstract

Objective

This study aimed to investigate the effect of ultrasound-diagnosed adenomyosis on assisted pregnancy outcomes, i.e., in vitro fertilization–embryo transfer (IVF–ET).

Methods

This was a retrospective cohort study of 18,568 women who had received their first frozen–thawed ET cycle in Center of Reproductive Medicine, Children's Hospital of Shanxi and Women Health Center of Shanxi and the Reproductive Medicine Center of Tianjin Central Obstetrics and Gynecology Hospital from January 2014 to May 2019. A total of 5,087 patients met the inclusion and exclusion criteria, and they were divided into two groups: adenomyosis with tubal factor infertility (study group, n = 193) and only tubal factor infertility (control group, n = 4894). After a 1:1 propensity score match (caliper value = 0.005), 360 cases were matched in the end.

Result

There was no statistical difference in the embryo implantation rate, clinical pregnancy rate, or multiple pregnancy rate between the two groups (28.4% vs. 31.7%, 42.2% vs. 42.8%, and 11.7% vs. 12.8%, respectively; P > 0.05). However, the early miscarriage rate in the adenomyosis group was significantly higher than that in the control group (13.3% vs. 5.6%, respectively; P = 0.012). The live birth rate was 22.8% in the women with adenomyosis and was observed to be significantly lower than 33.3% in the control group (P = 0.026). The patients with adenomyosis had a higher incidence of pregnancy complications than those without (4.4% vs. 0.6%, respectively; P = 0.018), but the neonatal birth weight was not related to adenomyosis.

Conclusion

Women with adenomyosis should be treated as being at high risk of early miscarriage. However, maternal adenomyosis has no effect on the birth weight of the newborn.

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Authors and Affiliations

  1. Tianjin Medical University, Tianjin, 300070, China

    Xiu-Ping Zhang, Rui Shi, Yao-Jia Zhang, Xiao-Mei Hu & Xin-Yu Hu

  2. Department of Gynecologic Oncology, Tianjin Central Hospital of Gynecology Obstetrics, No. 156 Sanma Road, Nankai, Tianjin, 300052, China

    Xiu-Ping Zhang & Yuan-Jing Hu

  3. Center of Reproductive Medicine, Children’s Hospital of Shanxi and Women Health Center of Shanxi, Taiyuan, 030013, China

    Xiu-Ping Zhang & Xue-Luo Zhang

  4. Tianjin Central Hospital of Gynecology Obstetrics/Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin, 300052, China

    Yin-Feng Zhang

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Contributions

X-PZ and Y-FZ conceived the idea and conceptualized the study. RS and Y-JZ collected the data. X-LZ and X-MH analyzed the data. X-YH and Y-JH drafted the manuscript, then X-LZ and Y-JH reviewed the manuscript. All authors read and approved the final draft.

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Correspondence to Yuan-Jing Hu.

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Zhang, XP., Zhang, YF., Shi, R. et al. Pregnancy outcomes of infertile women with ultrasound-diagnosed adenomyosis for in vitro fertilization and frozen–thawed embryo transfer. Arch Gynecol Obstet 304, 1089–1096 (2021). https://doi.org/10.1007/s00404-021-06011-z

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