New findings bring optimism for improved pregnancy success among women with adenomyosis who are using assisted reproduction
BEIJING, BEIJING, CHINA, September 7, 2026 /EINPresswire.com/ — Adenomyosis, a disorder impacting over one in five women globally, occurs when the uterine lining grows into the muscle wall. In addition to causing pain and discomfort, the condition creates substantial hurdles for those hoping to become pregnant. Assisted reproductive technologies (ART)—including in vitro fertilization (IVF) and embryo transfer (ET)—are known to yield lower success rates for pregnancy and live birth in women with adenomyosis. Consequently, enhancing these outcomes has become a key priority in reproductive medicine.
A potential strategy involves administering gonadotropin-releasing hormone analogue (GnRHa) before ET to temporarily reduce estrogen production. The rationale is that lowering specific hormone levels could create a more favorable uterine environment, thereby improving the chances of implantation and pregnancy. However, evidence for this method has been mixed; certain studies indicate benefit, others find no effect, and guidelines from different medical organizations conflict. Part of the inconsistency arises from research that fails to distinguish between fresh embryo transfers (ETs) and frozen embryo transfers (FETs)—two procedures with distinct biological characteristics.
To clarify this issue, a research team headed by Professors Tao Wu and Qing Xue from Peking University, China, performed a study evaluating GnRHa pre‑treatment separately for the two types of ETs. They combined their own patient data with a systematic review of existing literature. The paper became available online on December 17, 2024, and was published in Volume 132, Issue S2 of BJOG: An International Journal of Obstetrics & Gynaecology on April 15, 2025.
First, the team conducted a retrospective cohort study, examining outcomes from 413 treatment cycles across 369 women with adenomyosis treated at Peking University First Hospital between 2015 and 2023. They compared live birth rates, clinical pregnancy rates, and miscarriage rates between women who had received GnRHa pre‑treatment and those who had not, using statistical modeling to adjust for factors such as age, body mass index, uterine size, and embryo quality. Second, they performed a meta‑analysis, combining their results with those from six other studies on the same topic.
The findings were notably consistent and clear in both parts of the investigation. “After adjusting for confounders in our cohort study, the odds of achieving a live birth after ET or FET were 2.65 times and 2.43 times higher, respectively, for women with GnRHa pre‑treatment than for those without,” remarks Prof. Wu. The meta‑analysis confirmed this pattern, with women receiving GnRHa pre‑treatment showing significantly higher live birth rates after both ET and FET cycles. Notably, miscarriage rates did not differ significantly between the two groups.
Overall, the results support GnRHa pre‑treatment as a valuable option for women with adenomyosis undergoing either type of ET, and the authors recommend it should be actively considered in clinical practice. However, the researchers noted that all studies included in the meta‑analysis were conducted in China, which could limit the generalizability of the conclusions. “More worldwide studies on this topic and randomized controlled trials are warranted to strengthen this newfound evidence,” concludes Prof. Xue.
Overall, this study lays the groundwork for further research involving diverse international populations, paving the way for universally applicable clinical guidelines for treating adenomyosis in women undergoing assisted reproduction.
Reference
Title of original paper: Effect of GonadotropinReleasing Hormone Agonist PreTreatment on Outcomes of Fresh and Frozen Embryo Transfers in Women With Adenomyosis: A Retrospective Cohort Study With Literature Review
Journal: BJOG: An International Journal of Obstetrics & Gynaecology
DOI: 10.1111/1471-0528.18026
About Peking University, China
Peking University (PKU) is a public university located in Beijing, China. Established in 1898 as the Imperial University of Peking, it was the country’s first national comprehensive university. After merging with Beijing Medical University in 2000, PKU expanded into science, engineering, medicine, humanities, and social sciences. Today, it comprises six faculties, 55 schools and departments, and ten affiliated hospitals, enrolling over 48,600 students supported by more than 12,600 faculty and staff. PKU collaborates with nearly 400 universities and institutions across more than 60 countries, fostering world-class talent and contributing to a shared human future.
Website: https://english.pku.edu.cn/
About Professor Tao Wu from Peking University, China
Dr. Tao Wu is a Professor and Deputy Chair of the Department of Epidemiology and Biostatistics at the School of Public Health, Peking University, China. She earned her bachelor’s degree in Preventive Medicine from Beijing Medical University, her Master’s in Epidemiology from Peking University, and her Ph.D. in Genetic Epidemiology from Johns Hopkins University. Her research focuses on genetic epidemiology, chronic diseases, and public health education. She has led numerous national and municipal research grants and authored several publications in international peer‑reviewed journals, including Genetic Epidemiology, Diabetes Care, and BMC Med Educ.
About Professor Qing Xue from Peking University First Hospital, China
Dr. Qing Xue is a Professor and Director of the Reproductive Center at the First Hospital of Peking University, China. She completed her postdoctoral training at Northwestern University, USA, and holds both MD and PhD degrees. Dr. Xue is a member of the American Society for Reproductive Investigation, Standing Committee Member and Secretary‑General of the Fertility Protection Branch of the Chinese Preventive Medicine Association, Committee Member of the Reproductive Professional Committee of the Chinese Medical Doctor Association, Standing Committee Member of the Reproductive Medicine Branch and Obstetrics and Gynecology Microecology Medicine Branch of the China International Exchange and Promotive Association for Medical and Health Care, and Vice Chairman of the Reproductive Medicine Committee of the Beijing Chronic Disease Prevention and Health Education Research Association. Her research examines gene regulation in endometriosis and infertility, as well as the fetal‑maternal interface in endometriosis. She has published over 100 SCI papers, including in Nature Communications and Biomaterials. She has led 12 national and provincial research grants, including two sub‑projects under the National Key R&D Program of China (13th and 14th Five‑Year Plans) and six General Programs of the National Natural Science Foundation of China. Her honors include four provincial/ministerial awards, among them the Second Prize for National Maternal and Child Health Science and Technology.
Funding information
The study was supported by the National Key Research and Development Program of China (No. 2022YFC2704000) and the National High Level Hospital Clinical Research Funding (Interdisciplinary Clinical Research Project of Peking University First Hospital, No. 2022CR47).
Jing Ma
Wiley
+86 1085419367
jima@wiley.com
Visit us on social media:
Other
