Pregnancy outcomes and neonatal outcomes after pituitary down-regulation in patients with adenomyosis receiving IVF/ICSI and FET: results of a retrospective cohort study

The aim of this study was to analyze whether GnRH agonist treatment before frozen-thawed embryo transfer (FET) improved the pregnancy outcomes of adenomyosis patients and to study the effects of GnRH agonists to the health of offspring. This study was a retrospective analysis of 139 patients who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) between Jan 2011 and Dec 2014. For these patients, the total number of cycles was 212. The cycles were divided into groups A, B and C, according to different treatment methods before FET protocol. Group A consisted of non-adenomyosis patients who received pure hormone replacement therapy (HRT). Group B consisted of adenomyosis patients who received HRT. Group C consisted of adenomyosis patients who received GnRH agonist therapy and HRT. The patients' medical records were reviewed, including pregnancy outcomes and neonatal outcomes. Our study showed that among the adenomyosis patients, Group C had a significantly higher live birth rate than Group B (44.74% vs. 25%, P = 0.034). Neonatal outcomes, including birth weight, sex, birth defects, singleton vs. twins and mode of delivery, were compared. No differences were observed between the groups. GnRH agonist therapy before FET may offer a higher live birth rate in patients with adenomyosis. Our data appear to confirm other published findings that adenomyosis patients benefit from pre-FET pituitary down-regulation therapy. Additionally, the treatment itself appears not to increase birth defect risk.