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Hum. Reprod. Advance Access originally published online on November 3, 2005
Human Reproduction 2006 21(2):352-357; doi:10.1093/humrep/dei348
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial

Efstratios M. Kolibianakis1,3, Evangelos G. Papanikolaou2, Michel Camus2, Herman Tournaye2, Andre C. Van Steirteghem2 and Paul Devroey2

1 Unit for Human Reproduction, Aristotle University, GR 54603 Thessaloniki, Greece, and 2 Centre for Reproductive Medicine, Dutch-Speaking Brussels Free University, BE-1090 Brussels, Belgium

3 To whom correspondence should be addressed. E-mail: Stratis.Kolibianakis{at}otenet.gr

BACKGROUND: The objective of this randomized controlled trial was to assess the effect of oral contraceptive pill (OCP) pretreatment on the probability of ongoing pregnancy in patients treated with a GnRH antagonist for IVF. METHODS: A fixed dose of 200 IU recombinant FSH (rFSH) was started in 425 patients either on day 2 of the menstrual cycle (non-OCP group: n = 211) or 5 days after discontinuing the OCP (OCP group: n = 214). GnRH-antagonist was initiated on day 6 of stimulation, and triggering of final oocyte maturation was performed with 10,000 IU of HCG. RESULTS: Ongoing pregnancy rates per started cycle in the non-OCP and OCP group were 27.5% and 22.9%, respectively [95% confidence interval (CI) of the difference: –3.7 to +12.8]. Pregnancy loss was significantly increased in the OCP (36.4%) compared with the non-OCP group (21.6%) (95% CI of the difference: –28.4 to –2.3). CONCLUSION: Pretreatment with OCP, as compared with initiation of stimulation on day 2 of the cycle in patients treated with GnRH antagonist and recombinant FSH, appears to be associated with a not significant difference in ongoing pregnancy rates per started cycle and results in a significantly higher early pregnancy loss.

Key words: GnRH antagonists/oral contraceptive pill/randomized controlled trial/recombinant FSH


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