The effect of oral contraceptive pill for cycle scheduling prior to GnRH-antagonist protocol on IVF cycle parameters and pregnancy outcome.
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In a retrospective cohort of 1,799 IVF cycles using GnRH-antagonist protocols, oral contraceptive pretreatment for cycle scheduling increased stimulation duration and gonadotropin consumption without affecting implantation or pregnancy rates.
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Abstract
ObjectiveTo evaluate the effect of oral contraceptive pills (OCP) pretreatment on IVF cycle outcome in GnRH-antagonist protocol.DesignRetrospective cohort study.SettingMajor tertiary university-affiliated center.PatientsAll patients treated with GnRH antagonist in our IVF unit during the last 3 years were included in the study. Overall 1,799 IVF cycles were performed. Of these, in 604 cycles OCP pretreatment was used prior to GnRH-antagonist for cycle scheduling. Patients were divided into two age groups-young group aged or = 36 years.InterventionsThe young group underwent 927 cycles, 281 cycles with OCP pretreatment and 646 cycles without. The older group underwent 872 cycles, 323 cycles with OCP pretreatment and 549 cycles without. Data was analyzed within each age group.Main outcome measuresTreatment duration and total dose of FSH IU used for stimulation, number of oocytes retrieved, implantation and pregnancy rates.ResultsAll OCP-pretreated cycles required significantly longer stimulation than non-pretreated cycles (young: 10.76 vs. 9.21 days; older: 10.48 vs. 8.73 days, respectively) and higher total dose of FSH IU (young: 3,210 IU vs. 2,565 IU; older: 4,973 IU vs. 3,983 IU, respectively). There were no other differences in cycle characteristics between groups. Implantation and pregnancy rates were not affected by OCP pretreatment.ConclusionsOCP pretreatment can be offered as a mode for cycle scheduling prior to GnRH-antagonist protocol, though it may be associated with longer stimulation and higher gonadotropin consumption.
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