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Effects of different ovarian stimulation protocols on in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes in patients with adenomyosis: a retrospective cohort study
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  • Li Ge,
  • Yexing Li,
  • Lin Cui,
  • Zi-Jiang Chen
Li Ge

Corresponding Author:[email protected]

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Yexing Li
Shandong University Cheeloo College of Medicine
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Lin Cui
Shandong University
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Zi-Jiang Chen
Shandong Provincial Hospital Affiliated to Shandong University
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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 protocol 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.