The oral contraceptive pill effectively permits cycle batching for an intermittent in vitro fertilization programme in Trinidad and Tobago.
Assisted reproductive technology (ART) in small island states like Trinidad and Tobago is usually provided in batches so as to minimize the cost of providing the service. As a result, patients 'cycles have to be synchronized in order to coincide with the arrival of a visiting embryologist. This is a retrospective study which evaluates the experience of pre-treatment with an oral contraceptive pill (OCP) as a means of batching cycles for an intermittent ART programme. Seventy-four in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles in which OCP usage was employed (Group A), were compared with 121 cycles which did not require pharmaceutical manipulation (Group B). In both groups more than 50% of women were older than 36-years. Two cycles were cancelled in Group A and seven in Group B, because of poor ovarian response. Although the pregnancy rate per treatment cycle was higher in Group A than in Group B (26.3% vs 17.3%), this difference was not significant. More spontaneous miscarriages occurred in the non-OCP women and ovarian cyst formation was more common in these women. The authors experience indicates that the OCP is a simple, cheap and efficient means of batching patients for an intermittent ART programme and can be utilized in other small ART centres.
Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, The University of the West Indies. sramsewak@fms.uwi.tt
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Ramsewak
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Duffy
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Woodward
D000328:Adult; D003276:Contraceptives, Oral / Q000494:pharmacology*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007246:Infertility / Q000188:drug therapy* / Q000453:epidemiology; D008597:Menstrual Cycle / Q000187:drug effects* / Q000502:physiology; D011247:Pregnancy; D015397:Program Evaluation; D012189:Retrospective Studies; D014300:Trinidad and Tobago / Q000453:epidemiology
D003276:Contraceptives, Oral