Adenomyosis is known to impair implantation and pregnancy outcomes in in vitro fertilization, yet the optimal pre-treatment strategy remains unclear. To address this gap, a study compared low-dose letrozole with a gonadotropin releasing hormone agonist (GnRHa) on implantation markers and reproductive outcomes in 156 women with symptomatic diffuse adenomyosis undergoing frozen embryo transfer. The study found that low-dose letrozole and GnRH agonist pre-treatment produced similar clinical pregnancy (letrozole: 27.9% vs GnRHa: 29.9%), live birth (17.7% vs 19.5%), and miscarriage rates (22.7% vs 21.7%) in women with adenomyosis undergoing frozen embryo transfer.
Both treatments significantly improved endometrial receptivity, marked by increased progesterone receptor (PR) and integrin αvβ3 expression and significant downregulation of ERα, ERβ, VEGF and eNOS. Outer myometrial involvement was…
