title: Pretreatment with estrogen does not affect IVF-ICSI cycle outcome compared with no pretreatment in GnRH antagonist protocol: a prospective randomized trial.
abstract: OBJECTIVE
  To assess effects of estrogen pretreatment in GnRH antagonist protocol.
  
  
  METHODS
  Prospective, randomized multicenter study.
  
  
  METHODS
  Ten private or university-based centers.
  
  
  METHODS
  A total of 472 patients undergoing IVF/ICSI.
  
  
  METHODS
  Randomization by sealed envelopes to receive 17β-estradiol (4 mg/d) or no pretreatment before daily recombinant FSH administration started on the first day of estrogen discontinuation or on cycle day 2 in nonpretreated women.
  
  
  METHODS
  The primary outcome measure was the number of retrieved oocytes. Secondary efficacy variables included total FSH dose, cycle duration, and outcome.
  
  
  RESULTS
  The mean numbers of retrieved oocytes (10.9 ± 5.7 vs. 10.2 ± 5.6) and obtained embryos (5.5 ± 3.7 vs. 4.8 ± 3.7) were not significantly different between women allocated to estrogen pretreatment (n = 238) and no pretreatment (n = 234). Total FSH amount (1,557 ± 408 vs. 1,389 ± 347 IU) and stimulation duration (10.8 ± 1.4 vs. 10.0 ± 1.5 days) were slightly but significantly increased in pretreated patients. Positive pregnancy tests, ultrasound pregnancy rate, and delivery rate per cycle were similar (36%, 33%, and 26.6%, respectively, vs. 38.2%, 35.4%, and 30%).
  
  
  CONCLUSIONS
  These data confirm that estrogen pretreatment is associated with requirement of higher FSH doses and longer duration of stimulation without any significant increase in the number of retrieved oocytes. However, estrogen does not affect cycle outcome and therefore might be used in clinical practice for programming IVF retrievals during working days.
  
  
  BACKGROUND
  NCT01489852.
authors.affiliation: Service de Médecine de la Reproduction, Hôpital Jean Verdier, Assistance Publique-Hôpitaux de Paris, Université Paris XIII, Bondy, France. isabelle.cedrin-durnerin@jvr.ap-hop-paris.fr
authors.forename: Isabelle
authors.initials: I
authors.lastname: Cédrin-Durnerin
authors.forename: Anne
authors.initials: A
authors.lastname: Guivarc'h-Levêque
authors.forename: Jean-Noël
authors.initials: JN
authors.lastname: Hugues
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000008:administration & dosage*; D004967:Estrogens / Q000008:administration & dosage; D030762:Estrous Cycle / Q000187:drug effects; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000008:administration & dosage*; D007987:Gonadotropin-Releasing Hormone / Q000037:antagonists & inhibitors*; D006801:Humans; D054315:Oocyte Retrieval / Q000379:methods; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage; D020554:Sperm Injections, Intracytoplasmic / Q000379:methods*
chemical_list: D004967:Estrogens; D011994:Recombinant Proteins; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol; D005640:Follicle Stimulating Hormone