Effect of gonadotropin-releasing hormone agonist pretreatment time on the reproductive outcomes in infertile patients with adenomyosis
Jiao Tingting, Li Jianhua, Zhang Shuiwen, et al
Reproductive Medical Center, the Seventh Medical Center of PLA General Hospital, Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing 100700, China)
【Abstract】Objective To investigate the impact of gonadotropin-releasing hormone agonist(GnRH-a) pretreatment time on the reproductive outcomes of frozen-thawed embryo transfer (FET) ininfertile patients with adenomyosis. Method The clinical data of 317 patients with adenomyosis andinfertile treated by in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSIET) during FET cycle were collected from January 2019 to April 2020 in the Reproductive MedicalCenter, the Seventh Medical Center of PLA General Hospital. According to the pretreatment time ofGnRH-a before FET transfer, the patients were divided into 1 month group (n=97), 3 months group(n=139) and 6 months group (n=81). The basic data, clinical and laboratory conditions and pregnancyoutcomes were compared among the three groups. Statistical analysis performed by analysis of Varianceand χ 2 test. Result There were no signifificant difference in the age, body mass index (BMI), basal folliclestimulating hormone (FSH) level, basal sinus follicle number, infertility years, and adenomyosis type of thethree groups (all P>0.05). There were no statistically signifificant difference in the number of gonadotropin(Gn) days, total Gn dose, number of eggs obtained, fertilization rate, cleavage rate, number of high-qualityembryos, endometrium thickness on transformation days, number of embryos transferred and uterine volumebefore treatment (all P>0.05). The average uterine volume after treatment in 1 month group was larger thanthat in the 3 months group and 6 months [(216±149), (157±101), (142±89) cm3
, t=3.874, 4.309, P<0.01].There were no significant difference in the number of transferred embryos, embryo implantation rate andmiscarriage rate among the three groups (all P>0.05). The clinical pregnancy rate of the three groups ofpatients was signifificantly different (χ 2 =6.468, P=0.039). Among them, the clinical pregnancy rate of 3 monthsgroup was higher than that in the 1 month group and 6 months group [66.9% (93/139), 53.6% (52/97), 51.9%(42/81), χ
2
=4.265, 4.892, all P<0.05]. There was a statistically significant difference in the live birth rateamong the three groups (χ
2
=6.020, P=0.049), and the live birth rate in the 3 months group was higher thanthat in the 1 month group and 6 months group [55.4% (77/139), 42.3% (41/97), 40.7% (33/81), χ
2
=3.938,4.397, all P<0.05]. Conclusion The use of GnRH-a pretreatment before FET embryo in patients withadenomyosis and infertile can effectively reduce the uterine volume, and the treatment for 3 months hasa higher clinical pregnancy rate and live birth rate
[J]. 发育医学电子杂志, 2022, 10(6): 417-422.
Jiao Tingting, Li Jianhua, Zhang Shuiwen, et al. Effect of gonadotropin-releasing hormone agonist pretreatment time on the reproductive outcomes in infertile patients with adenomyosis. Journal of Developmental Medicine(Electronic Version), 2022, 10(6): 417-422.