title: Successive and cyclic oral contraceptive pill pretreatment improves IVF/ICSI outcomes of PCOS patients and ameliorates hyperandrogenism and antral follicle excess.
abstract: OBJECTIVE
  To evaluate different oral contraceptive pill (OCP) pretreatment associated differential in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes of polycystic ovary syndrome (PCOS) patients and explore enhanced hormonal balance induced by the pretreatment.
  
  
  METHODS
  This retrospective study included 500 PCOS women and 565 normal ovulating counterparts undergoing IVF/ICSI. The PCOS patients were divided into three groups based on the OCP pretreatment regimens: non-OCP (without OCP pretreatment), unsuccessive OCP (the period of successive pretreatment ≤2 months) and successive OCP (the period of successive pretreatment ≥3 months) groups. Comprehensive hormonal and ultra-sonographic assessments were performed before/after IVF pretreatment. Confounding factors affecting pregnancy outcomes were analyzed with logistic regression.
  
  
  RESULTS
  PCOS patients with significant endocrine disorders had reduced implantation and pregnancy rates and increased miscarriage rate. Successive, not unsuccessive OCP pretreatment, significantly improved the implantation and pregnancy rates, and reduced the incidence of monotocous small-for-gestational age infants, which was accompanied by remarkably decreased hyperandrogenism and antral follicles.
  
  
  CONCLUSIONS
  PCOS is an independent risk factor for poor IVF outcome. Successive, not unsuccessive, OCP cyclical pretreatment could improve pregnancy outcome of PCOS patients, associated with reduction of hyperandrogenism and antral follicle excess.
authors.affiliation: The Key Laboratory of Reproductive Genetics, Ministry of Education, Zhejiang University , Hangzhou, Zhejiang , China .
authors.forename: Jie-Xue
authors.initials: JX
authors.lastname: Pan
authors.forename: Ye
authors.initials: Y
authors.lastname: Liu
authors.forename: Zhang-Hong
authors.initials: ZH
authors.lastname: Ke
authors.forename: Cheng-Liang
authors.initials: CL
authors.lastname: Zhou
authors.forename: Qing
authors.initials: Q
authors.lastname: Meng
authors.forename: Guo-Lian
authors.initials: GL
authors.lastname: Ding
authors.forename: Gu-Feng
authors.initials: GF
authors.lastname: Xu
authors.forename: Jian-Zhong
authors.initials: JZ
authors.lastname: Sheng
authors.forename: He-Feng
authors.initials: HF
authors.lastname: Huang
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D003279:Contraceptives, Oral, Sequential / Q000627:therapeutic use*; D005260:Female; D005307:Fertilization in Vitro; D005317:Fetal Growth Retardation / Q000209:etiology / Q000517:prevention & control; D006785:Hospitals, University; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology / Q000517:prevention & control*; D007247:Infertility, Female / Q000209:etiology / Q000628:therapy*; D010044:Outpatient Clinics, Hospital; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology / Q000517:prevention & control*; D010062:Ovulation Induction / Q000009:adverse effects*; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies; D020554:Sperm Injections, Intracytoplasmic; D013223:Statistics as Topic; D055815:Young Adult
chemical_list: D003279:Contraceptives, Oral, Sequential
keywords: ICSI; IVF; PCOS; oral contraceptive pill; pregnancy outcome