Objective The objective of this study is to evaluate the effectiveness of prolonged GnRH agonist (GnRH‐a) suppression combined with letrozole and intensive luteal phase support in a patient with severe adenomyosis undergoing frozen‐thawed embryo transfer (FET). Design The study design was a case report. Setting The setting was a tertiary referral in vitro fertilization (IVF) clinic. Subjects The subject was a 41‐year‐old woman with a history of primary infertility with severe adenomyosis and endometriosis. Her partner presented with nonobstructive azoospermia. Exposure Following micro‐TESE, ovarian stimulation, and ICSI, the patient received prolonged combined GnRH‐a and letrozole suppression before two attempts of single euploid frozen embryo transfer (eFET). Main Outcome Measures The main outcome measure was pregnancy outcome. Results The first eFET cycle with 3 months of suppression resulted in an early miscarriage at 7 weeks. In the second cycle, a prolonged 5‐month suppression led to a significant reduction of the uterine size, lower serum estradiol levels, and optimal endometrial preparation, achieving an ongoing pregnancy and delivery of a healthy baby at 36 weeks of gestation. Conclusion This case supports the potential benefit of extended GnRH‐a and letrozole suppression with intensive luteal phase support for patients with severe adenomyosis, suggesting that individualized protocols may be beneficial and warrant further investigation in similar complex cases.
Fatemi et al. (Thu,) studied this question.
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