Korean J Obstet Gynecol.  2011 Oct;54(10):599-604. 10.5468/KJOG.2011.54.10.599.

Oral contraceptive pill pretreatment in ovarian stimulation with GnRH antagonists for in vitro fertilization: A comparative study

• Choo YS
• Han AR
• Yang SH
• Sung NY
• Cha SH
• Kim HO
• Park CW
• Song IO
• Koong MK
• Kang IS
• Yang KM

• KMID: 1836745
• DOI: http://doi.org/10.5468/KJOG.2011.54.10.599

Abstract

OBJECTIVE
To evaluate whether oral contraceptive pill (OCP) pretreatments in gonadotropin-releasing hormone (GnRH) antagonist ovarian stimulation protocols takes positive effects on in vitro fertilization (IVF) outcomes in respect to retrieved oocyte number, oocyte maturation rate, fertilization rate, good quality embryo rate, cycle cancellation rate, pregnancy rate and clinical abortion rate.
METHODS
A total of 194 cycles using GnRH antagonist protocol was performed at infertility clinic of our institute from September 1st, 2009 to February 28th, 2010. The medical records of GnRH antagonist protocols for IVF with or without OCP pretreatment in our IVF unit were retrospectively analyzed. We compared the IVF outcomes between OCP pretreated (n=41) and no pretreatment group (n=153).
RESULTS
In cycles with OCP pretreated group, the total used dosage of gonadotropin (3019.38+/-1379.00 IU) were higher than that of no pretreatment group (2551.52 +/- 1157.05 IU, P = 0.054). The duration of ovarian stimulation in OCP pretreated group (11.5 +/- 2.0) was significantly longer than that of control group (9.5 +/- 1.9, P = 0.000). The number of gained total embryo (2.8+/-0.9 vs. 2.5+/-1.0, P = 0.055) and fertilization rate (77.2% vs. 65.5%, P = 0.017) were significantly higher in OCP pretreated group. There is no significant difference in pregnancy rate between two groups (39.4% vs. 30.0%, P = 0.304).
CONCLUSION
OCP pretreatment before GnRH antagonist protocol for IVF appears not to have reliable benefit in terms of IVF outcomes. Well-controlled and large-scaled studies are needed.

Keyword

Gonadotropin-releasing hormone antagonist; Oral contraceptive pill pretreatment; Ovarian stimulation; In vitro fertilization

MeSH Terms

Embryonic Structures
Fertilization
Fertilization in Vitro
Gonadotropin-Releasing Hormone
Gonadotropins
Infertility
Medical Records
Oocytes
Ovulation Induction
Pregnancy Rate
Retrospective Studies
Gonadotropin-Releasing Hormone
Gonadotropins

Figure

• 

  Fig. 1. Histogram of IVF outcomes of GnRH antagonist protocol with or without OCP pretreatment. IVF, in vitro fertilization; GnRH, gonadotropin-releasing hormone; OCP, oral contraceptive pill; COH, controlled ovarian hyperstimulation. aStatistically significant (P-value < 0.05). bP-value = 0.055.

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