A large study published in Frontiers in Endocrinology explored the effects of adenomyosis on the fertility of women undergoing assisted reproductive technology (ART). It found that women with adenomyosis face increased risks of miscarriage and obstetric complications during ART treatment.
Although adenomyosis is common in infertile women, its impact on in vitro fertilization and embryo transfer (IVF-ET) success remains unclear. This study, conducted at Peking University Third Hospital’s Reproductive Centre in China, aimed to address that question.
The research analyzed medical records of women who underwent their first IVF/intracytoplasmic sperm injection (ICSI) treatment between January 2011 and December 2020. Women with adenomyosis, aged 40 or younger, and diagnosed by at least two experienced sonographers were included. The researchers focused on those with uterine volumes of ≥ 56 cm³ and those undergoing freshly stimulated and day-3 cleavage-stage transfers for tubal factor infertility.
The study included 1,146 women with adenomyosis and a matching group of 1,146 control women. The control group consisted of women with normal uteruses who received IVF treatment for tubal ligation.
The clinical pregnancy rates between the two groups were similar: 38.1% for women with adenomyosis versus 41.6% for the control group. However, other fertility outcomes were significantly worse for women with adenomyosis. The implantation rate was 25.6% for the adenomyosis group compared to 28.6% for the control group. The live birth rate was 26% for the adenomyosis group, while it was 31.5% for the control group. Additionally, the miscarriage rate was higher in the adenomyosis group: 29.1% versus 17.2% in the control group.
After adjusting for factors like age and body mass index, the study found no significant difference in clinical pregnancy rates between the groups. However, women with adenomyosis experienced higher risks of miscarriage, placenta previa, and preeclampsia. The odds of miscarriage were nearly twice as high for the adenomyosis group, and the chances of developing placenta previa or preeclampsia were also significantly increased.
The study suggests two possible explanations for the increased miscarriage risk in women with adenomyosis. First, disruptions in the endometrial-myometrium interaction may affect the endometrium, making it less receptive to implantation. Second, inflammatory responses and free radical formation could lead to abnormal implantation and increased risk of miscarriage. The authors also hypothesize that changes in the myometrium could cause problems with the reshaping of the spiral arteries, affecting placental development.
In conclusion, this study highlights the negative impact of adenomyosis on IVF-ET outcomes and obstetric complications. The findings emphasize the importance of thorough consultation and careful management of ART in women with adenomyosis. Further research is needed to develop better treatments for adenomyosis and improve fertility outcomes for affected women.
Related Topics:
- Understanding Your Menstrual Cycle and Its Impact on Fertility
- Understanding PCOS: A Path to Managing Fertility and Health
- Understanding a Failed Fertility Cycle: What Comes Next
