Effect of extended hormonal suppression in patients with adenomyosis undergoing embryo transfer - PubMed
4 hours ago
- #adenomyosis
- #hormonal suppression
- #embryo transfer
- Adenomyosis is an estrogen-dependent uterine disorder causing infertility and adverse obstetric outcomes.
- Optimal medical preparation before embryo transfer (ET) in adenomyosis patients remains uncertain.
- Adenomyotic lesions create a hyperestrogenic, inflammatory, and architecturally distorted uterine environment, impairing endometrial receptivity and increasing miscarriage risk.
- Extended hormonal suppression strategies include ultra-long GnRHa regimens, GnRHa plus aromatase inhibitors, levonorgestrel-releasing intrauterine systems, oral dienogest, and continuous combined oral contraceptives.
- Prolonged GnRHa pretreatment, especially in freeze-all strategies with frozen ET, may improve implantation and reduce miscarriage rates.
- Progestin-based approaches show promise but require further study, while combined oral contraceptives mainly offer symptom control.
- Current studies highlight heterogeneity and methodological limitations, emphasizing the need for well-designed trials to optimize hormonal suppression regimens.