Study design and population
Patients with adenomyosis who underwent in vitro fertilization(IVF) or intracytoplasmic sperm injection (ICSI) at the Center for Reproductive Medicine, Shandong University from January 2016 to December 2020 were involved in the study. The follow-up time was up to June 2022. The inclusion criteria were as follows: (i) age below 42 years at the start of the IVF/ICSI cycles (ii) diagnosis of adenomyosis based on subjective enlargement of the uterine corpus and heterogeneous myometrium, accompanying with asymmetrical thickening, cysts, hyperechoic islands, fan-shaped shadowing, echogenic subendometrial lines and buds, translesional vascularity, irregular junctional zone and interrupted junctional zone or not(10, 11) (iii) no history of uterine malformation, untreated hydrosalpinx or intrauterine lesions (iv) undergoing fresh ET or FET cycle for no more than the third time. All scans were performed by experienced imaging doctors, who had over 8 years of experience in gynecological practice. The baseline data of scans were recorded on the electronic medical system.