Page 50 - ESHRE2019

Studies evaluating the effects of treatment of adenomyosis on fertility/IVF outcome.
Authors
Study Design
Study Population
Patients Group A (n)
Patients Group B (n)
Method of diagnosis
Treatment
Outcome
Al Jama et al. (2011) (40)
Retrospective cohort study
Infertile patients with adenomyosis
18 patients treated with surgery + GnRHa
22 patients treated with GnRHa alone
TVUS and MRI
6 courses of GnRHa
Spontaneous pregnancy within 3 years period
Wang et al. (2009) (41)
Retrospective cohort study
patients with adenomyosis and unexplained infertility
28 surgery +/‐ GnRHa therapy
37
6 mths GnRHa
TVUS and pathology
Surgery vs 6m GnRHa
Spontaneous pregnancy within 3 years period
Niu et al. (2013) (38)
Retrospective cohort study
Infertile women with adenomyosis undergoing Frozen embryo transfer
194 treated with GnRHa and HRT
145 treated with HRT alone
TVUS
leuprolide acetate 3.75mg, 28 days later 1.875mg and 21 days later plus HRT, or HRT alone
Clinical pregnancy after one cycle
Park et al. (2016) (39)
Retrospective cohort study
Infertile women with adenomyosis undergoing Fresh or frozen embryo transfer
87 women/ 105 cycles with GnRHa treatment before fresh transfer
116 women/ 147 cycles without GnRHa treatment before fresh transfer
TVUS
Goserelin 3.75 mg for 2‐3 months
Clinical pregnancy after 1‐ 2 IVF cycle
GnRHa 3‐6 months before IVF is associated with conception.
9
Effects of pretreatment with GnRHa before IVF in women with adenomyosis
Odds ratio meta-analysis plot [fixed effects]
Niu et al
Park et al
combined [fixed]
3.22 (1.96, 5.32)
1.30 (0.72, 2.36)
2.23 (1.57, 3.17)
5 10
0.5 1 2
odds ratio (95% confidence interval)
10
48
45