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Hum. Reprod. Advance Access published online on November 3, 2005
Human Reproduction, 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
Received June 13, 2005
Revised August 9, 2005
Accepted September 8, 2005

Article

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. Kolibianakis 1*, Evangelos G. Papanikolaou 2, Michel Camus 2, Herman Tournaye 2, Andre C. Van Steirteghem 2, and Paul Devroey 2

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

* To whom correspondence should be addressed.
Efstratios M. Kolibianakis, E-mail: Stratis.Kolibianakis{at}otenet.gr


  Abstract

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.

Keywords: GnRH antagonists/oral contraceptive pill/randomized controlled trial/recombinant FSH.
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