Treatment of Adenomyosis in Patients Undergoing In Vitro Fertilization
Clinical Scenario
This protocol addresses patients with adenomyosis who are undergoing in vitro fertilization (IVF). The presence of adenomyosis in this setting introduces specific pre-treatment considerations that must be addressed before embryo transfer.
Patient Population
Patients with adenomyosis proceeding through an IVF cycle — whether planning a fresh or frozen embryo transfer — may benefit from a structured pre-treatment phase to improve reproductive outcomes.
Treatment Approach (Partial)
The protocol centres on hormonal pre-treatment strategies administered before embryo transfer. The specific agents, their conditions of use, and the complete sequencing of this regimen are detailed in the full structured protocol below.
References
DOI: 10.1016/j.jogc.2023.04.008
- For patients with adenomyosis undergoing in vitro fertilization, gonadotropin-releasing hormone agonist downregulation for a period of 2 to 4 months may be considered before transferring fresh or frozen embryos (weak, low).
- Pre-treatment regimens before fresh or frozen embryo transfer such as a 2- to 4-month GnRH agonist course or the LNG-IUS have been proposed to improve the reproductive outcomes of patients undergoing in vitro fertilization.
- A retrospective cohort study of 358 patients found a significantly increased ongoing pregnancy rate (41.8% versus 29.5%) in women with adenomyosis treated with the LNG-IUS for 3 months before frozen embryo transfer.
View source ↗