title: Effect of adenomyosis on in vitro fertilization/intracytoplasmic sperm injection outcomes in infertile women: a retrospective cohort study.
abstract: OBJECTIVE
  To study the effect of adenomyosis on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in infertile patients.
  
  
  METHODS
  We performed a retrospective, database-searched cohort study based on 10,268 patients undergoing controlled ovarian hyperstimulation and IVF/ICSI between 2009 and 2011 in our unit. Adenomyosis was diagnosed by transvaginal ultrasound. A high-quality matched cohort study with strict inclusion criteria was conducted. We compared the basic characteristics and main IVF/ICSI outcomes between the two groups.
  
  
  RESULTS
  We identified 83 patients with adenomyosis, of whom we included 77, and strictly matched them to 77 patients without adenomyosis. Higher day 3 estrogen levels and a longer duration of gonadotropin stimulation days were found in women with adenomyosis compared to control subjects. Patients with adenomyosis had a nonsignificant trend toward a lower clinical pregnancy rate and a higher miscarriage rate (p = 0.103 and 0.09, respectively). The delivery rate was significantly lower in the adenomyosis group in comparison to the matched controls (p = 0.022).
  
  
  CONCLUSIONS
  Within the limitations of a retrospective study (albeit with a remarkably large number of observations), our results suggest that transvaginal ultrasound-diagnosed adenomyosis could have a negative impact on the main IVF/ICSI outcomes. Improving the diagnostic validity and scoring of disease severity in patients with adenomyosis is suggested.
authors.affiliation: Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Provincial Hospital Affiliated to Shandong University, Jinan, PR China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yan
authors.forename: Lingling
authors.initials: L
authors.lastname: Ding
authors.forename: Rong
authors.initials: R
authors.lastname: Tang
authors.forename: Zi-Jiang
authors.initials: ZJ
authors.lastname: Chen
mesh_terms: D062788:Adenomyosis / Q000473:pathology*; D000328:Adult; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000473:pathology* / Q000628:therapy; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods* / Q000592:standards