Hum. Reprod. Advance Access originally published online on April 21, 2006
Human Reproduction 2006 21(8):2121-2125; doi:10.1093/humrep/del121
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A prospective trial comparing oocyte donor ovarian response and recipient pregnancy rates between suppression with gonadotrophin-releasing hormone agonist (GnRHa) alone and dual suppression with a contraceptive vaginal ring and GnRH
1 Servicio de Medicina de la Reproducción and 2 Unidad de Bioestadística, Departamento de Obstetricia y Ginecología, Institut Universitari Dexeus, Barcelona, Spain
3 To whom correspondence should be addressed at: Servicio de Medicina de la Reproducción, Institut Universitari Dexeus, P Bonanova, 67, 08017 Barcelona, Spain. E-mail: pacmar{at}dexeus.com
BACKGROUND: Contraceptive treatment before gonadotrophin-releasing hormone agonist administration presents advantages in women with a tendency to hyper-response and simplifies donorrecipient treatment synchronization. This study compares response to gonadotrophin stimulation under hypophyseal suppression in oocyte donors with or without vaginal contraceptive pretreatment. METHODS: One hundred and ninety oocyte donors were recruited in a single centre and prospectively assigned to one of two treatment groups, according to the day of the week menstruation initiated: Group VC, no prior vaginal contraceptive and Group VC+, prior vaginal contraceptive. RESULTS: VC+ patients presented a significantly higher cancellation rate, lower plasma estradiol levels and fewer follicles >12 mm on the day of hCG, versus the VC group. Number of oocytes recovered was significantly lower in the VC+ group. All the cases of severe ovarian hyperstimulation syndrome (SOHSS) were in the VC group. Pregnancy rates by embryo transfer to synchronic recipients were similar between VC+ and VC (59.5 versus 57.9%, respectively). CONCLUSIONS: Vaginal contraceptive pretreatment resulted in a higher ovarian suppression, whereas SOHSS rate was lower than in donors who did not receive pretreatment. There were no differences in pregnancy rates between the two groups of synchronic oocyte recipients.
Key words: oocyte donor/ovarian response/dual suppression/GnRHa/contraceptive vaginal ring