Oral contraceptive pill pretreatment in ovarian stimulation with GnRH antagonists for IVF: a systematic review and meta-analysis.
OBJECTIVE
To assess the impact of oral contraceptive pill (OCP) pretreatment in ovarian stimulation for in vitro fertilization (IVF) using gonadotropin releasing hormone (GnRH) antagonists.


METHODS
Systematic review and meta-analysis of randomized controlled trials (RTC).


METHODS
University IVF center.


METHODS
Infertile patients (n = 847), treated in four trials.


METHODS
Systematic literature search (MEDLINE, EMBASE, CENTRAL COCHRANE, conference proceedings, reference lists) for randomized trials on OCP treatment before stimulation with gonadotropins and GnRH antagonist for IVF. Meta-analysis of data yielding pooled odds ratios (OR) or weighted differences of the means (WMD) and 95% confidence intervals (CI).


METHODS
Ongoing pregnancy rate per randomized woman.


RESULTS
Ongoing pregnancy rate per randomized woman was not found to be significantly different between patients with and those without OCP pretreatment (OR: 0.74, 95% CI: 0.53 to 1.03). Duration of gonadotropin stimulation (WMD: +1.41 days, 95% CI: +1.13 to +1.68) and gonadotropin consumption (WMD: +542 IU, 95% CI: +127 to +956) were significantly increased after OCP pretreatment. No significant differences were observed regarding the number of cumulus-oocyte complexes (COCs) and the fertilization rates.


CONCLUSIONS
A significant difference in ongoing pregnancy rates between patients who received OCP pretreatment and those who did not is currently not present, although further studies are necessary for more solid conclusions on pregnancy likelihood to be drawn.
Griesinger
George
G
Department of Obstetrics and Gynecology, University Clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
Venetis
Christos A
CA
Marx
Tanja
T
Diedrich
Klaus
K
Tarlatzis
Basil C
BC
Kolibianakis
Efstratios M
EM
D003276:Contraceptives, Oral / Q000008:administration & dosage*; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro / Q000706:statistics & numerical data*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology* / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D011292:Premedication / Q000379:methods / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data
D003276:Contraceptives, Oral; D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone