Han Bing, Liang Tingting, Zhang Wen, Ma Caihong, Qiao Jie
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital Beijing 100000, China; National Clinical Research Center for Obstetrics and Gynecology (Peking University Third Hospital) Beijing 100000, China; Key Laboratory of Assisted Reproduction, Ministry of Education (Peking University) Beijing 100000, China; Beijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology Beijing 100000, China.
Department of Obstetrics and Gynecology, The Second Hospital of Shanxi Medical University, Taiyuan City 030000, China.
Reprod Biomed Online. 2023 Feb;46(2):346-351. doi: 10.1016/j.rbmo.2022.09.021. Epub 2022 Sep 26.
What is the effect of adenomyosis types on IVF and embryo transfer (IVF-ET) after ultra-long gonadotrophin-releasing hormone (GnRH) agonist protocol?
Patients who underwent the first cycle of IVF-ET with ultra-long GnRH agonist protocol were included in this retrospective cohort study. They were divided into three groups: (A) 428 patients with diffuse adenomyosis; (B) 718 patients with focal adenomyosis; and (C) 519 patients with tubal infertility. Reproduction outcomes were analysed.
Logistic regression analysis revealed that, compared with focal adenomyosis and tubal infertility, diffuse adenomyosis was negatively associated with clinical pregnancy and live birth (clinical pregnancy: A versus B: OR 0.708, 95% CI 0.539 to 0.931, P = 0.013; A versus C: OR 0.663, 95% CI 0.489 to 0.899, P = 0.008; live birth: A versus B: OR 0.530, 95% CI 0.385 to 0.730, P < 0.001; A versus C: OR 0.441, 95% CI 0.313 to 0.623, P < 0.001), but positively associated with miscarriage (A versus B: OR 1.727, 95% CI 1.056 to 2.825, P = 0.029; A versus C: OR 2.549, 95% CI 1.278 to 5.082, P = 0.008). Compared with patients with tubal infertility, focal adenomyosis was also a risk factor for miscarriage (B versus C: OR 1.825, 95% CI 1.112 to 2.995, P = 0.017).
Compared with patients with focal adenomyosis or tubal infertility, the reproduction outcomes of IVF-ET in patients with diffuse adenomyosis seems to be worse.
在超长促性腺激素释放激素（GnRH）激动剂方案下，子宫腺肌病的类型对体外受精-胚胎移植（IVF-ET）有何影响？
本回顾性队列研究纳入了接受超长GnRH激动剂方案的首次IVF-ET周期的患者。他们被分为三组：（A）428例弥漫性子宫腺肌病患者；（B）718例局灶性子宫腺肌病患者；（C）519例输卵管性不孕患者。分析生殖结局。
逻辑回归分析显示，与局灶性子宫腺肌病和输卵管性不孕相比，弥漫性子宫腺肌病与临床妊娠和活产呈负相关（临床妊娠：A组与B组：OR 0.708，95%CI 0.539至0.931，P = 0.013；A组与C组：OR 0.663，95%CI 0.489至0.899，P = 0.008；活产：A组与B组：OR 0.530，95%CI 0.385至0.730，P < 0.001；A组与C组：OR 0.441，95%CI 0.313至0.623，P < 0.001），但与流产呈正相关（A组与B组：OR 1.727，95%CI 1.056至2.825，P = 0.029；A组与C组：OR 2.549，95%CI 1.278至5.082，P = 0.008）。与输卵管性不孕患者相比，局灶性子宫腺肌病也是流产的一个危险因素（B组与C组：OR 1.825，95%CI 1.112至2.995，P = 0.017）。
与局灶性子宫腺肌病或输卵管性不孕患者相比，弥漫性子宫腺肌病患者IVF-ET的生殖结局似乎更差。
