Advertisement

Effect of pretreatment oral contraceptives on fresh and cumulative live birth in vitro fertilization outcomes in ovulatory women

  • Yao Lu
    Affiliations
    Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People’s Republic of China
    Search for articles by this author
  • Yuan Wang
    Affiliations
    Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People’s Republic of China
    Search for articles by this author
  • Ting Zhang
    Affiliations
    Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People’s Republic of China
    Search for articles by this author
  • Guiquan Wang
    Affiliations
    Department of Reproductive Endocrinology, Women’s Hospital, School of Medicine, Zhejiang University, Zhejiang, People’s Republic of China
    Search for articles by this author
  • Yaqiong He
    Affiliations
    Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People’s Republic of China
    Search for articles by this author
  • Steven R. Lindheim
    Affiliations
    Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, Ohio
    Search for articles by this author
  • Zhangsheng Yu
    Affiliations
    Department of Bioinformatics and Biostatistics, Shanghai Jiao Tong University −Yale Joint Center for Biostatistics, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
    Search for articles by this author
  • Yun Sun
    Correspondence
    Reprint requests: Yun Sun, M.D., Ph.D., Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics 845 Lingshan Road, Pudong New District, Shanghai 200135, PR China.
    Affiliations
    Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People’s Republic of China
    Search for articles by this author

      Objective

      To evaluate the impact of oral contraceptives (OC) on live birth rate (LBR) following a fresh embryo transfer and cumulative live birth rate (cLBR) in normal ovulatory women undergoing in vitro fertilization (IVF).

      Design

      Retrospective cohort study.

      Setting

      Reproductive center.

      Patients

      A total of 3,110 normo-ovulatory women aged 20–40 years undergoing IVF either using or not using OC pretreatment in their first autologous cycle.

      Intervention(s)

      Patients initiated gonadotropins for their IVF cycle either after a spontaneous menses or following OC pretreatment, which was at the discretion of the provider or according to patients preference.

      Main Outcome Measure(s)

      The primary outcomes were LBR after fresh transfer (fLBR) and cLBR.

      Results

      fLBR was significantly lower in women using OC compared to those not (42.6% vs. 52.8%). Although LBR after frozen embryo transfer cycles were similar (42.7% vs. 41.1%), cLBR was significantly lower in women using OC (62.8% vs. 67.6%). Multivariate logistic and COX regression analysis adjusting for baseline characteristics demonstrated that IVF cycle synchronization with OC was significantly associated with a lower fLBR (adjusted odds ratio 0.73, 95% confidence interval 0.62−0.86) and cLBR (adjusted hazard ratio 0.89, 95% confidence interval 0.80−0.98).

      Conclusions

      Pretreatment OC use is associated with a reduction in fLBR and cLBR.
      Efectos de la administración pretratamiento de anticonceptivos orales sobre los resultados de recién nacidos en fresco y acumulados de fecundación in vitro en mujeres ovuladoras.

      Objetivo

      Evaluar el impacto de los anticonceptivos orales (OC) sobre la tasa de nacido vivo (LBR) tras una transferencia de embrión en fresco y la tasa de nacido vivo acumulada (cLBR) en mujeres normovuladoras que realizan un ciclo de fecundación in vitro (IVF).

      Diseño

      Estudio de cohorte retrospectiva.

      Escenario

      Centro de reproducción.

      Paciente(s)

      Un total de 3.110 mujeres normovuladoras entre 20 y 40 años, en tratamiento de IVF bien con, o bien sin, pretratamiento con OC en su primer ciclo autólogo.

      Intervención(es)

      Las pacientes iniciaron las gonadotropinas para su ciclo de IVF bien tras una menstruación espontánea, bien tras el pretratamiento con OC, determinado por criterio médico o de acuerdo con la preferencia de la paciente.

      Medida de resultado principal(es)

      El resultado primario fue LBR tras transferencia en fresco (fLBR) y la cLBR.

      Resultado(s)

      La fLBR fue significativamente menor en mujeres que tomaron la OC comparadas con aquellas que no la tomaron (42.6% vs. 52.8%). Aunque la LBR en los ciclos de transferencia de embriones congelados fue similar (42.7% vs. 41.1%), la cLBR fue significativamente menor en las mujeres que tomaron OC (62.8% vs. 67.6%). Los estudios de regresión logística multivariable y de regresión de COX ajustados respecto a las características basales demostraron que la sincronización del ciclo de IVF con OC se asoció con una menor fLBR (odds ratio ajustadas 0.73, intervalo de confianza 95% 0.62-0.86) y menor cLBR (razón de riesgo ajustada 0.89, intervalo de confianza del 95% 0.80-0.98).

      Conclusión(es)

      el pretratamiento con OC se asocia con una reducción de fLBR y de cLBR.

      Key Words

      To read this article in full you will need to make a payment

      References

        • Farquhar C.
        • Rombauts L.
        • Kremer J.A.
        • Lethaby A.
        • Ayeleke R.O.
        Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques.
        Cochrane Database Syst Rev. 2017; 5CD006109
        • Yildiz B.O.
        Approach to the patient: contraception in women with polycystic ovary syndrome.
        J Clin Endocrinol Metab. 2015; 100: 794-802
        • Keltz M.D.
        • Gera P.S.
        • Skorupski J.
        • Stein D.E.
        Comparison of FSH flare with and without pretreatment with oral contraceptive pills in poor responders undergoing in vitro fertilization.
        Fertil Steril. 2007; 88: 350-353
        • Kim C.H.
        • Jeon G.H.
        • Cheon Y.P.
        • Jeon I.
        • Kim S.H.
        • Chae H.D.
        • et al.
        Comparison of GnRH antagonist protocol with or without oral contraceptive pill pretreatment and GnRH agonist low-dose long protocol in low responders undergoing IVF/intracytoplasmic sperm injection.
        Fertil Steril. 2009; 92: 1758-1760
        • Bozdag G.
        • Esinler I.
        • Yarali H.
        Pretreatment with oral contraceptive pills does not influence the pregnancy rate in the long leuprolide acetate protocol.
        Gynecol Obstet Invest. 2012; 73: 53-57
        • Garcia-Velasco J.A.
        • Fatemi H.M.
        To pill or not to pill in GnRH antagonist cycles: that is the question!.
        Reprod Biomed Online. 2015; 30: 39-42
        • Wei D.
        • Shi Y.
        • Li J.
        • Wang Z.
        • Zhang L.
        • Sun Y.
        • et al.
        Effect of pretreatment with oral contraceptives and progestins on IVF outcomes in women with polycystic ovary syndrome.
        Hum Reprod. 2017; 32: 354-361
        • Xu Z.
        • Meng L.
        • Pan C.
        • Chen X.
        • Huang X.
        • Yang H.
        Does oral contraceptives pretreatment affect the pregnancy outcome in polycystic ovary syndrome women undergoing ART with GnRH agonist protocol?.
        Gynecol Endocrinol. 2019; 35: 124-127
        • McCartney C.R.
        • Marshall J.C.
        Clinical practice. Polycystic ovary syndrome.
        N Engl J Med. 2016; 375: 54-64
        • Andersen A.N.
        • Witjes H.
        • Gordon K.
        • Mannaerts B.
        Predictive factors of ovarian response and clinical outcome after IVF/ICSI following a rFSH/GnRH antagonist protocol with or without oral contraceptive pre-treatment.
        Hum Reprod. 2011; 26: 3413-3423
        • Goodman N.F.
        • Cobin R.H.
        • Futterweit W.
        • Glueck J.S.
        • Legro R.S.
        • Carmina E.
        American Association of Clinical Endocrinologist, American College of Endocrinology, and Androgen Excess and PCOS Society Disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome—part I.
        Endocr Pract. 2015; 21: 1291-1300
        • Gray S.H.
        Menstrual disorders.
        Pediatr Rev. 2013; 34: 6-17
        • Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group
        Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome.
        Fertil Steril. 2004; 81: 19-25
      1. Chen Y, Tao L, Lin Y, Li X, Ma C. Outcomes of in vitro fertilization-embryo transfer in women with diminished ovarian reserve after growth hormone pretreatment. Gynecol Endocrinol. In press.

        • World Health Organization
        WHO Laboratory Manual for the Examination and Processing of Human Semen.
        5th ed. World Health Organization, Geneva2010
        • Matsuura K.
        • Hayashi N.
        • Takiue C.
        • Hirata R.
        • Habara T.
        • Naruse K.
        Blastocyst quality scoring based on morphologic grading correlates with cell number.
        Fertil Steril. 2010; 94: 1135-1137
        • Pereira N.
        • Petrini A.C.
        • Zhou Z.N.
        • Lekovich J.P.
        • Kligman I.
        • Rosenwaks Z.
        Pretreatment of normal responders in fresh in vitro fertilization cycles: a comparison of transdermal estradiol and oral contraceptive pills.
        Clin Exp Reprod Med. 2016; 43: 228-232
        • Rodriguez-Purata J.
        • Devesa M.
        • Parriego M.
        • Pardos C.
        • Rodriguez I.
        • Polyzos N.P.
        • et al.
        Linking back-to-back stimulation cycles with oral contraceptives or progestins in women undergoing embryo accumulation for preimplantation genetic testing, a retrospective study.
        Gynecol Endocrinol. 2018; 34: 955-960
        • Decanter C.
        • Robin G.
        • Thomas P.
        • Leroy M.
        • Lefebvre C.
        • Soudan B.
        • et al.
        First intention IVF protocol for polycystic ovaries: does oral contraceptive pill pretreatment influence COH outcome?.
        Reprod Biol Endocrinol. 2013; 11: 54
        • Pinkas H.
        • Sapir O.
        • Avrech O.M.
        • Ben-Haroush A.
        • Ashkenzi J.
        • Fisch B.
        • et al.
        The effect of oral contraceptive pill for cycle scheduling prior to GnRH-antagonist protocol on IVF cycle parameters and pregnancy outcome.
        J Assist Reprod Genet. 2008; 25: 29-33
        • Creus M.
        • Ordi J.
        • Fábregues F.
        • Casamitjana R.
        • Carmona F.
        • Cardesa A.
        • et al.
        The effect of different hormone therapies on integrin expression and pinopode formation in the human endometrium: a controlled study.
        Hum Reprod. 2003; 18: 683-693
        • Bermejo A.
        • Iglesias C.
        • Ruiz-Alonso M.
        • Blesa D.
        • Simón C.
        • Pellicer A.
        • et al.
        The impact of using the combined oral contraceptive pill for cycle scheduling on gene expression related to endometrial receptivity.
        Hum Reprod. 2014; 29: 1271-1278
        • Maheshwari A.
        • McLernon D.
        • Bhattacharya S.
        Cumulative live birth rate: time for a consensus?.
        Hum Reprod. 2015; 30: 2703-2707