Hormone pre-treatment may boost IVF live birth rates in women with adenomyosis

Peking University researchers found that gonadotropin-releasing hormone analogue pre-treatment was linked to higher live birth rates in women with adenomyosis undergoing fresh or frozen embryo transfer. The findings, published in BJOG, may help shape future fertility treatment guidance, though the authors say more global studies are needed.

Why it matters: - Adenomyosis affects more than one in five women worldwide and can make conception harder. - The condition is linked to lower success rates for assisted reproductive technologies such as in vitro fertilization and embryo transfer. - Any treatment that improves live birth rates could change care for patients trying to conceive.

What happened: - A Peking University research team led by Professors Tao Wu and Qing Xue studied whether gonadotropin-releasing hormone analogue, or GnRHa, pre-treatment improved outcomes for women with adenomyosis undergoing embryo transfer. - The paper was available online on Dec. 17, 2024, and published in BJOG: An International Journal of Obstetrics & Gynaecology on April 15, 2025. - The study analyzed fresh embryo transfers and frozen embryo transfers separately.

The details: - Researchers reviewed 413 treatment cycles in 369 women with adenomyosis treated at Peking University First Hospital from 2015 to 2023. - The cohort study compared live birth, clinical pregnancy and miscarriage rates between women who received GnRHa pre-treatment and those who did not. - Statistical modeling adjusted for age, body mass index, uterine size and embryo quality. - The team also ran a meta-analysis that pooled its findings with six other studies. - In the adjusted cohort analysis, GnRHa pre-treatment was associated with 2.65 times higher odds of live birth after fresh embryo transfer and 2.43 times higher odds after frozen embryo transfer. - The meta-analysis found significantly higher live birth rates with GnRHa pre-treatment in both fresh and frozen embryo transfer cycles. - Miscarriage rates did not differ significantly between the groups. - The original paper is titled “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.” - The study was supported by China's National Key Research and Development Program and National High Level Hospital Clinical Research Funding. - The article included a DOI: 10.1111/1471-0528.18026. - The announcement included a university website and a journal page.

Between the lines: - The result matters because prior evidence on GnRHa pre-treatment has been mixed, and earlier studies often did not separate fresh from frozen embryo transfers. - The fact that both the cohort study and the meta-analysis pointed in the same direction strengthens the signal. - The authors said the evidence may not apply everywhere because all studies in the meta-analysis were conducted in China. - That geographic limit leaves open the question of whether the same benefit appears in more diverse patient populations.

What's next: - The researchers called for more international studies and randomized controlled trials. - Wider testing could help determine whether GnRHa pre-treatment should become part of routine clinical practice for adenomyosis patients undergoing assisted reproduction. - Future evidence may support more universal treatment guidelines for this group.

The bottom line: - Peking University researchers found that GnRHa pre-treatment may improve live birth odds for women with adenomyosis undergoing embryo transfer, but broader studies are still needed before the approach can be widely generalized.