Adenomyosis has no adverse effects on IVF/ICSI outcomes in women with endometriosis treated with long-term pituitary down-regulation before IVF/ICSI.
OBJECTIVE
To establish the effect of adenomyosis on IVF/ICSI outcomes in infertile patients with endometriosis who were pretreated with long-term (>/=3 months) GnRH-agonist prior to IVF/ICSI.


METHODS
Retrospective study in 74 infertile patients with surgically proven endometriosis who were treated with IVF/ICSI between January 2002 and March 2007. The diagnosis of adenomyosis was based on transvaginal ultrasound criteria. All patients were pretreated with long-term (>or=3 months) GnRH-agonist prior to IVF/ICSI.


RESULTS
90.4% of the patients were diagnosed with endometriosis rASRM stages III-IV. Adenomyosis was demonstrated in 27% of them and was predominantly located in the posterior wall of the uterus. The following IVF/ICSI outcomes were found: a mean duration of GnRH-agonist use prior to IVF/ICSI of 5.35 months (3-26); a mean dosage of FSH used of 208IU (75-450); the mean number of oocytes retrieved was 8.73 (1-30); the mean number of embryos obtained was 3.86 (0-16); the mean number of embryos transferred was 1.6; a mean fertilization rate of 43.6%; a mean implantation rate of 26.3%; a mean miscarriage rate of 24.3%; and a clinical pregnancy rate (fetal heart activity on ultrasound beyond 12 weeks of gestation) of 31.7%. No significant differences were found for any of the IVF/ICSI outcomes between women with and without adenomyosis.


CONCLUSIONS
Adenomyosis had no adverse effects on IVF/ICSI outcomes in infertile women with proven endometriosis who were pretreated with long-term GnRH-agonist.
Mijatovic
V
V
Department of Reproductive Medicine, Endometriosis Center VUmc, De Boelelaan 1117, 1081 HVAmsterdam, The Netherlands. mijatovic@vumc.nl
Florijn
E
E
Halim
N
N
Schats
R
R
Hompes
P
P
D000328:Adult; D015536:Down-Regulation; D004715:Endometriosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D005307:Fertilization in Vitro; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D010062:Ovulation Induction; D010902:Pituitary Gland / Q000187:drug effects; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome; D014463:Ultrasonography
D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide