title: Dual suppression with oral contraceptive pills in GnRH antagonist cycles for patients with polycystic ovary syndrome undergoing intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To evaluate the effects of a gonadotropin-releasing hormone (GnRH) antagonist protocol, with or without oral contraceptive pill (OCP) pretreatment, in patients with polycystic ovary syndrome (PCOS) undergoing intracytoplasmic sperm injection (ICSI).
  
  
  METHODS
  In this retrospective cohort study, 410 infertile patients with PCOS were assessed in their first ICSI cycles between January 2006 and June 2013. In Group A (n=208), patients underwent a long luteal GnRH agonist protocol, and in Groups B (n=143) and C (n=59), patients underwent a GnRH antagonist protocol. The patients in Group C also received OCPs containing 30mg of ethinyl oestradiol and 3mg of drospirenone prior to treatment. The main outcome measures were pregnancy and ovarian hyperstimulation syndrome (OHSS) rates.
  
  
  RESULTS
  Demographic features, body mass index, duration of infertility, serum baseline hormone levels, cycle outcomes, multiple pregnancy rates, miscarriage rates, OHSS rates, total number of Grade A embryos and total number of transferred embryos were comparable between the groups. Clinical pregnancy rates were 27.4%, 26.6% and 23.7% in Groups A, B and C, respectively (p=0.853).
  
  
  CONCLUSIONS
  OCP pretreatment was found to have no beneficial or adverse effects in patients with PCOS undergoing a GnRH antagonist protocol for ICSI, but can be used for cycle scheduling.
authors.affiliation: Department of Obstetrics and Gynaecology, Ankara University School of Medicine, Ankara, Turkey. Electronic address: batuhanozmen@gmail.com.
authors.forename: B
authors.initials: B
authors.lastname: Ozmen
authors.affiliation: Department of Obstetrics and Gynaecology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Y E
authors.initials: YE
authors.lastname: Sükür
authors.affiliation: Department of Obstetrics and Gynaecology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: M M
authors.initials: MM
authors.lastname: Seval
authors.affiliation: Department of Biostatistics, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Ateş
authors.affiliation: Department of Obstetrics and Gynaecology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: C S
authors.initials: CS
authors.lastname: Atabekoğlu
authors.affiliation: Department of Obstetrics and Gynaecology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Sönmezer
authors.affiliation: Department of Obstetrics and Gynaecology, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Berker
mesh_terms: D000328:Adult; D000736:Androstenes / Q000627:therapeutic use; D015331:Cohort Studies; D003277:Contraceptives, Oral, Combined / Q000627:therapeutic use; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004624:Embryo Transfer; D004997:Ethinyl Estradiol / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D016729:Leuprolide / Q000627:therapeutic use*; D016471:Ovarian Hyperstimulation Syndrome; D010062:Ovulation Induction / Q000379:methods*; D011085:Polycystic Ovary Syndrome / Q000150:complications*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D016896:Treatment Outcome
chemical_list: D000736:Androstenes; D003277:Contraceptives, Oral, Combined; D003278:Contraceptives, Oral, Hormonal; D005300:Fertility Agents, Female; C534342:drospirenone and ethinyl estradiol combination; D007987:Gonadotropin-Releasing Hormone; D004997:Ethinyl Estradiol; D016729:Leuprolide; C061018:ganirelix
keywords: GnRH agonist; GnRH antagonist; ICSI; Oral contraceptive; PCOS