4.6 Article

The impact of adenomyosis on the outcome of IVF-embryo transfer

Journal

REPRODUCTIVE BIOMEDICINE ONLINE
Volume 35, Issue 5, Pages 549-554

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.rbmo.2017.06.026

Keywords

Adenomyosis; Clinical pregnancy rate; Fertility; IVF; Ultrasound

Funding

  1. National Institute for Health Research [CL-2012-18-004] Funding Source: researchfish

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Our study examined the impact of adenomyosis on the chance of clinical pregnancy after IVF and embryo transfer (IVF-ET). This was a prospective multicentre study from April 2013 to October 2015. We included 375 women with history of infertility who attended for a 3D scan prior to IVF-ET. A total of 150/375 (40.0%, 95% confidence interval [CI] 35.2-45.0) women had clinical pregnancy. Women with any feature of adenomyosis had a lower clinical pregnancy rate (21/72 [29.2%, 95% CI 18.6-39.6] versus 129/303 [42.6%, 95% CI 37.1-48.2], P = 0.044, relative risk (RR) 0.68 [95% CI 0.471.00]). Logistic regression selected an adenomyosis score of 4 or higher as an independent predictor of clinical pregnancy (odds ratio [OR] 0.35 [95% CI 0.15-0.82]). Estimated probability of clinical pregnancy decreased from 42.7% (95% CI 37.1-48.3) for women with no adenomyosis features to 22.9% (95% CI 13.4-32.6) for those with four and 13.0% (95% CI 2.2-23.9) for those with all seven. Women with adenomyosis have lower clinical pregnancy rate after IVF-ET. Condition severity expressed as a number of morphological features on ultrasound scan increases the magnitude of the effect. (C) 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

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