Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis
Objectives Pregnancy outcomes of different ovarian stimulation protocols for in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) in patients with adenomyosis are not explicit. This meta-analysis aimed to systematically evaluate the effects of different IVF/ICSI protocols on pregnancy...
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BMJ Publishing Group
2024-07-01
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| Online Access: | https://bmjopen.bmj.com/content/14/7/e077025.full |
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| author | Wenting Wang Li Ge Linlin Cui Jiayi Zhou Yexing Li Xueqing Zhao Xiaojing Chen Zhongyuan Li Pengbo Ge |
| author_facet | Wenting Wang Li Ge Linlin Cui Jiayi Zhou Yexing Li Xueqing Zhao Xiaojing Chen Zhongyuan Li Pengbo Ge |
| author_sort | Wenting Wang |
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| description | Objectives Pregnancy outcomes of different ovarian stimulation protocols for in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) in patients with adenomyosis are not explicit. This meta-analysis aimed to systematically evaluate the effects of different IVF/ICSI protocols on pregnancy outcomes.Design Meta-analysis.Data sources PubMed, Web of Science and Cochrane library were searched up to October 2023.Eligibility criteria Comparative studies on IVF/ICSI outcomes in the adenomyosis population were eligible. Studies on preimplantation genetic testing, reviews, case reports and animal experiments were excluded.Data extraction and synthesis Valid information was extracted by two independent authors according to a standard data format. All analyses were conducted using Review Manager (RevMan, V.5.3).Results Compared with the non-adenomyosis population, adenomyosis was responsible for a 26% reduction in clinical pregnancy rate (CPR; 42.47% vs 55.89%, OR: 0.74, 95% CI: 0.66 to 0.82, p<0.00001), a 35% reduction in live birth rate (LBR; 30.72% vs 47.77%, OR: 0.65, 95% CI: 0.58 to 0.73, p<0.00001) and a 1.9-fold increase in miscarriage rate (MR; 27.82% vs 13.9%, OR: 1.90, 95% CI: 1.56 to 2.31, p<0.00001). Subgroup analysis suggested that, in fresh embryo transfer (ET) cycles, the CPR (34.4% vs 58.25%) in the long/short/antagonist protocol group was poorer than that in the ultralong protocol group. In frozen ET (FET) cycles, there were no statistical differences in CPR ((GnRHa+FET) AM(adenomyosis) vs non-AM: 51.32% vs 43.48%, p=0.31; (non-GnRHa+FET) AM vs non-AM: 50.25% vs 60.10%, p=0.82), MR ((GnRHa+FET) AM vs non-AM:12.82% vs 12.50%, p=0.97; (non-GnRHa+FET) AM vs non-AM: 30.5% vs 15.54%, p=0.15) and LBR ((GnRHa+FET) AM vs non-AM:44.74% vs 36.96%, p=0.31; (non-GnRHa+FET) AM vs non-AM: 34.42% vs 50.25%, p=0.28). The MR in the adenomyosis group was high in the fresh ET and FET cycles.Conclusions FET might be a better choice for women with adenomyosis, especially those pretreated with GnRHa. In fresh ET cycles, pregnancy outcomes of the long/short/antagonist protocols were poorer than those of the ultralong protocol.Trial registration number CRD42022340743. |
| format | Article |
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| language | English |
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| spelling | doaj-art-c8e6010e9d174ad48cf55b2c86e573de2025-08-20T03:01:02ZengBMJ Publishing GroupBMJ Open2044-60552024-07-0114710.1136/bmjopen-2023-077025Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysisWenting Wang0Li Ge1Linlin Cui2Jiayi Zhou3Yexing Li4Xueqing Zhao5Xiaojing Chen6Zhongyuan Li7Pengbo Ge81 Center for Reproductive Medicine, The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China1 Center for Reproductive Medicine, The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China1 Center for Reproductive Medicine, The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China9 Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy ofMedical Sciences (No.2021RU001), Jinan, China2 Department of Obstetrics and Gynecology, Shanxi Children`s Hospital, Shanxi Maternal and Child Health Hospital, Taiyuan, Shanxi, China9 Research Unit of Gametogenesis and Health of ART-Offspring, Chinese Academy ofMedical Sciences (No.2021RU001), Jinan, China3 State Key Laboratory of Reproductive Medicine and Offspring Health, Centerfor Reproductive Medicine, Institute of Women, Children and ReproductiveHealth, Shandong University, Jinan, Shandong, China1 Center for Reproductive Medicine, The Second Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China10 Department of General Surgery, The First Affiliated Hospital of Xi`an Medical University, Shaanxi, ChinaObjectives Pregnancy outcomes of different ovarian stimulation protocols for in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) in patients with adenomyosis are not explicit. This meta-analysis aimed to systematically evaluate the effects of different IVF/ICSI protocols on pregnancy outcomes.Design Meta-analysis.Data sources PubMed, Web of Science and Cochrane library were searched up to October 2023.Eligibility criteria Comparative studies on IVF/ICSI outcomes in the adenomyosis population were eligible. Studies on preimplantation genetic testing, reviews, case reports and animal experiments were excluded.Data extraction and synthesis Valid information was extracted by two independent authors according to a standard data format. All analyses were conducted using Review Manager (RevMan, V.5.3).Results Compared with the non-adenomyosis population, adenomyosis was responsible for a 26% reduction in clinical pregnancy rate (CPR; 42.47% vs 55.89%, OR: 0.74, 95% CI: 0.66 to 0.82, p<0.00001), a 35% reduction in live birth rate (LBR; 30.72% vs 47.77%, OR: 0.65, 95% CI: 0.58 to 0.73, p<0.00001) and a 1.9-fold increase in miscarriage rate (MR; 27.82% vs 13.9%, OR: 1.90, 95% CI: 1.56 to 2.31, p<0.00001). Subgroup analysis suggested that, in fresh embryo transfer (ET) cycles, the CPR (34.4% vs 58.25%) in the long/short/antagonist protocol group was poorer than that in the ultralong protocol group. In frozen ET (FET) cycles, there were no statistical differences in CPR ((GnRHa+FET) AM(adenomyosis) vs non-AM: 51.32% vs 43.48%, p=0.31; (non-GnRHa+FET) AM vs non-AM: 50.25% vs 60.10%, p=0.82), MR ((GnRHa+FET) AM vs non-AM:12.82% vs 12.50%, p=0.97; (non-GnRHa+FET) AM vs non-AM: 30.5% vs 15.54%, p=0.15) and LBR ((GnRHa+FET) AM vs non-AM:44.74% vs 36.96%, p=0.31; (non-GnRHa+FET) AM vs non-AM: 34.42% vs 50.25%, p=0.28). The MR in the adenomyosis group was high in the fresh ET and FET cycles.Conclusions FET might be a better choice for women with adenomyosis, especially those pretreated with GnRHa. In fresh ET cycles, pregnancy outcomes of the long/short/antagonist protocols were poorer than those of the ultralong protocol.Trial registration number CRD42022340743.https://bmjopen.bmj.com/content/14/7/e077025.full |
| spellingShingle | Wenting Wang Li Ge Linlin Cui Jiayi Zhou Yexing Li Xueqing Zhao Xiaojing Chen Zhongyuan Li Pengbo Ge Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis BMJ Open |
| title | Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis |
| title_full | Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis |
| title_fullStr | Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis |
| title_full_unstemmed | Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis |
| title_short | Effect of different treatment protocols on in vitro fertilisation/intracytoplasmic sperm injection (IVF/ICSI) outcomes in adenomyosis women: a systematic review and meta-analysis |
| title_sort | effect of different treatment protocols on in vitro fertilisation intracytoplasmic sperm injection ivf icsi outcomes in adenomyosis women a systematic review and meta analysis |
| url | https://bmjopen.bmj.com/content/14/7/e077025.full |
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