Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial.
BACKGROUND
The objective of this randomized controlled trial was to assess the effect of oral contraceptive pill (OCP) pretreatment on the probability of ongoing pregnancy in patients treated with a GnRH antagonist for IVF.


METHODS
A fixed dose of 200 IU recombinant FSH (rFSH) was started in 425 patients either on day 2 of the menstrual cycle (non-OCP group: n = 211) or 5 days after discontinuing the OCP (OCP group: n = 214). GnRH-antagonist was initiated on day 6 of stimulation, and triggering of final oocyte maturation was performed with 10,000 IU of HCG.


RESULTS
Ongoing pregnancy rates per started cycle in the non-OCP and OCP group were 27.5% and 22.9%, respectively [95% confidence interval (CI) of the difference: -3.7 to +12.8]. Pregnancy loss was significantly increased in the OCP (36.4%) compared with the non-OCP group (21.6%) (95% CI of the difference: -28.4 to -2.3).


CONCLUSIONS
Pretreatment with OCP, as compared with initiation of stimulation on day 2 of the cycle in patients treated with GnRH antagonist and recombinant FSH, appears to be associated with a not significant difference in ongoing pregnancy rates per started cycle and results in a significantly higher early pregnancy loss.
Kolibianakis
Efstratios M
EM
Unit for Human Reproduction, Aristotle University, GR 54603 Thessaloniki, Greece. Stratis.Kolibianakis@otenet.gr
Papanikolaou
Evangelos G
EG
Camus
Michel
M
Tournaye
Herman
H
Van Steirteghem
Andre C
AC
Devroey
Paul
P
D000328:Adult; D003276:Contraceptives, Oral / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000235:genetics / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006727:Hormone Antagonists / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000628:therapy; D010062:Ovulation Induction; D011247:Pregnancy; D018873:Pregnancy Rate; D011994:Recombinant Proteins / Q000627:therapeutic use
D003276:Contraceptives, Oral; D005300:Fertility Agents, Female; D006727:Hormone Antagonists; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D005640:Follicle Stimulating Hormone