Abstract
Objective: to evaluate effects of different ovarian stimulation
protocols on in vitro fertilization(IVF) or intracytoplasmic sperm
injection (ICSI) outcomes in infertile women with adenomyosis.
Design: A retrospective, cohort study
Setting: Tertiary referral hospital
Population: A total of 562 cycles were included in the study
with 257 cycles of fresh ET and 305 cycles of FET in patients with
adenomyosis.
Methods: According to ovarian stimulation protocols in fresh ET
and embryo origin in FET, ultra-long, long, short and antagonist
subgroups were divided.
Main Outcomes Measure(s) :clinical pregnancy rate (CPR),
implantation rate(IR), miscarriage rate (MR) and live birth rate (LBR).
Results: Compared with ultra-long and long protocols, IR
(28.2% versus 49.7%, 52.1%, P=0.001) and CPR (35.6% versus 64.3%,
57.4%, P=0.004) in short protocol significantly decreased. Similarly, a
decreased inclination of IR (33.3% versus 49.7%, 52.1%) and CPR
(38.2% versus 57.4%, 64.3%) existed in antagonist protocol, although
no statistical significance was detected because of strict P adjustment
of Bonferroni method (Padj=0.008). Compared with long protocol, LBR in
short protocol decreased obviously (48.2% versus 20.3%,
P<0.001). LBR in antagonist protocol was also similarly poor
(39.8% versus 26.5% and 20.3%). In FET cycles, no matter which origin
of embryo, IR, CPR and LBR had no statistical difference.
Conclusions: In fresh ET cycles, ultra-long or long protocol
could be appropriate choices. whole embryo frozen combined with FET
might recover the poor outcomes of antagonist and short protocols in
fresh ET. embryo origin had no impact on pregnancy outcomes in FET
cycles.