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Hum. Reprod. Advance Access published online on April 21, 2006
Human Reproduction, doi:10.1093/humrep/del121
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© The Author 2006. 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 January 17, 2006
Revised March 22, 2006
Accepted March 23, 2006

Article

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

F. Martínez 1 *, M. Boada 1, B. Coroleu 1, E. Clua 1, N. Parera 1, I. Rodríguez 2, and P.N. Barri 1

1 Servicio de Medicina de la Reproducción, Institut Universitari Dexeus, P Bonanova, 67, 08017 Barcelona, Spain
2 Unidad de Bioestadística, Departamento de Obstetricia y Ginecología, Institut Universitari Dexeus, Barcelona, Spain

* To whom correspondence should be addressed.
F. Martínez, E-mail: pacmar{at}dexeus.com


  Abstract

BACKGROUND: Contraceptive treatment before gonadotrophin-releasing hormone agonist administration presents advantages in women with a tendency to hyper-response and simplifies donor-recipient 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.

Keywords: oocyte donor/ovarian response/dual suppression/GnRHa/contraceptive vaginal ring.
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