{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:18:08Z","timestamp":1774621088563,"version":"3.50.1"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":67,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Obstetrics and Gynecology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"\n Objective<\/jats:title>\n The objective of this study is to evaluate the effectiveness of prolonged GnRH agonist (GnRH\u2010a) suppression combined with letrozole and intensive luteal phase support in a patient with severe adenomyosis undergoing frozen\u2010thawed embryo transfer (FET).<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n The study design was a case report.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The setting was a tertiary referral in vitro fertilization (IVF) clinic.<\/jats:p>\n <\/jats:sec>\n \n Subjects<\/jats:title>\n The subject was a 41\u2010year\u2010old woman with a history of primary infertility with severe adenomyosis and endometriosis. Her partner presented with nonobstructive azoospermia.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Following micro\u2010TESE, ovarian stimulation, and ICSI, the patient received prolonged combined GnRH\u2010a and letrozole suppression before two attempts of single euploid frozen embryo transfer (eFET).<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measures<\/jats:title>\n The main outcome measure was pregnancy outcome.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The first eFET cycle with 3\u2009months of suppression resulted in an early miscarriage at 7\u2009weeks. In the second cycle, a prolonged 5\u2010month 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\u2009weeks of gestation.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n This case supports the potential benefit of extended GnRH\u2010a 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.<\/jats:p>\n <\/jats:sec>","DOI":"10.1155\/crog\/4150637","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T10:53:21Z","timestamp":1773053601000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Advanced Management of Severe Adenomyosis in IVF: A Personalized Approach With Extended GnRH Agonist and Letrozole Therapy"],"prefix":"10.1155","volume":"2026","author":[{"given":"Charline","family":"Fatemi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonalyn","family":"Edades","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2841-5745","authenticated-orcid":false,"given":"Ibrahim","family":"ElKhatib","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Ruiz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6922-1264","authenticated-orcid":false,"given":"Laura 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