Study of pregnancy outcomes after in vitro fertilization/intracytoplasmic sperm injection in young infertile patients with adenomyosis

Abstract

Objective To analyze the pregnancy outcomes of in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in infertility patients with adenomyosis aged less than 35 years. Methods Retrospective analysis was performed on the pregnancy outcomes of 2651 patients who underwent IVF/ICSI treatment and obtained clinical pregnancy in Reproductive Medicine Center of Nanjing Drum Tower Hospital from January 2014 to December 2017. Among them, adenomyosis group had 129 cases of adenomyosis with infertility patients; control group had 2522 cases of tubal factor infertility patients. Results 1) There were no significant differences in age, infertility duration, body mass index, number of basal sinus follicle and past reproductive histories between the two groups (P>0.05). 2) In patients undergoing IVF, the spontaneous miscarriage rate in the adenomyosis group was significantly higher than that in control group (13.79% vs. 6.96%, P=0.009). There were no significant differences in gestational age, fetal weight, and preterm delivery rate between the two groups (P>0.05). In patients undergoing ICSI, there were no significant differences in the spontaneous miscarriage rate, gestational age, fetal weight, and preterm delivery rate between the two groups (P>0.05). 3) Single pregnancy group and twin pregnancy group were compared respectively. In single pregnancy patients, the spontaneous miscarriage rate in adenomyosis group was higher than that in control group (12.05% vs. 6.31%, P=0.040). In twin pregnancy patients, gestational weeks of patients in adenomyosis group were significantly less than those in control group [(35.68±3.35) weeks vs. (36.72±1.99) weeks, P=0.002]. There were no significant differences in gestational age in single pregnancy patients between the two groups (P>0.05). There were no statistically significant differences in fetal weight and preterm delivery rates between adenomyosis group and control group, regardless of single or twin pregnancies (P>0.05). 4) In twin pregnancy patients, gestational age and fetal weight were significantly lower than those in single pregnancy patients (P<0.000 1), and preterm birth rate was significantly higher than that in single pregnancy patients (P<0.000 1). Conclusion For infertile patients less than 35 years, adenomyosis significantly increases the risk of IVF spontaneous miscarriage, but does not increase the risk of premature birth and low birth weight. Twin pregnancies significantly increased the risk of IVF/ICSI preterm birth and low birth weight in both adenomyosis and tubal infertility. Key words: Fertilization in vitro; Embryo transfer; Pregnancy outcome; Adenomyosis