title: Pretreatment of normal responders in freshin vitrofertilization cycles: A comparison of transdermal estradiol and oral contraceptive pills.
abstract: OBJECTIVE
  The aim of this study was to investigate the impact of pretreatment with transdermal estradiol (E2) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing freshin vitrofertilization (IVF)-embryo transfer (ET) cycles.
  
  
  METHODS
  A retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal E2versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded.
  
  
  RESULTS
  A total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal E2and OCP groups, respectively. Patients in the OCP group had a longer duration of COS (10.7±1.63 days,p<0.01) than the E2group (9.92±1.94 days). Patients in the OCP group also required higher cumulative doses of gonadotropins (2,657.3±1,187.9 IU) than those in the E2group (2,550.1±1,270.2 IU,p=0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups.
  
  
  CONCLUSIONS
  Our findings suggest that compared to OCPs, pretreatment with transdermal E2is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.
authors.affiliation: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Nigel
authors.initials: N
authors.lastname: Pereira
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Allison C
authors.initials: AC
authors.lastname: Petrini
authors.affiliation: Department of Obstetrics and Gynecology, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Zhen N
authors.initials: ZN
authors.lastname: Zhou
authors.affiliation: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Jovana P
authors.initials: JP
authors.lastname: Lekovich
authors.affiliation: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Isaac
authors.initials: I
authors.lastname: Kligman
authors.affiliation: Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Zev
authors.initials: Z
authors.lastname: Rosenwaks
keywords: Contraceptives, Oral, Combined; In vitro fertilization; Reproductive techniques, Assisted; Superovulation; Transdermal patch