Effect of Gonadotropin‐Releasing Hormone Agonist Pre‐Treatment on Outcomes of Fresh and Frozen Embryo Transfers in Women With Adenomyosis: A Retrospective Cohort Study With Literature Review.

Objectives: To investigate the effect of gonadotropin‐releasing hormone agonist (GnRHa) pre‐treatment on the clinical outcomes of fresh and frozen embryo transfers (ETs and FETs, respectively) in infertile patients with adenomyosis. Design: Retrospective cohort study with literature review. Setting: Peking University First Hospital. Population: We analysed 413 cycles of 369 women with adenomyosis who underwent ETs or FETs. Methods: We performed logistic regression analysis and meta‐analysis to assess the association of GnRHa pre‐treatment with the clinical outcomes of ETs and FETs. Main Outcome Measures: The live birth rate (LBR) was compared between patients with and without GnRHa pre‐treatment. Results: The LBR was higher in the GnRHa pre‐treatment group than in the non‐GnRHa pre‐treatment group in ETs (41.27% vs. 24.32%, p = 0.034) and FETs (40.36% vs. 20.75%, p = 0.008). The odds of achieving a live birth of women with GnRHa pre‐treatment were 2.65 times higher than that of those without (95% CI: 1.19–5.92, p = 0.017) after adjusting for confounders in ETs. Similarly, the adjusted odds ratio (OR) was 2.43 (95% CI: 1.10–5.40, p = 0.029) in FETs. For the meta‐analysis, eight studies met the inclusion criteria; however, only six reported the adjusted ORs. Combination of these six adjusted ORs with our results revealed that the GnRHa pre‐treatment group had higher LBRs than the non‐GnRHa pre‐treatment group (ET: OR 1.71, 95% CI: 1.30–2.26, FET: OR 2.61, 95% CI: 1.52–4.49). Conclusions: In women with adenomyosis, GnRHa pre‐treatment may be beneficial for LBRs following both ETs and FETs. [ABSTRACT FROM AUTHOR]