Value of Oral Contraceptive Pill Pretreatment before GnRH Antagonist Ovarian Stimulation Protocol on The Outcome of IVF/ICSI | ||||
| The Egyptian Journal of Fertility of Sterility | ||||
| Article 7, Volume 17, Issue 1 - Serial Number 11106352, January 2013, Page 28-31 PDF (1.4 MB) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/egyfs.2013.257470 | ||||
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| Author | ||||
| Ahmed T. Soliman | ||||
| Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University | ||||
| Abstract | ||||
| Objective: To evaluate the effect of oral contraceptive pill (OCP) pretreatment in gonadotropin-releasing hormone (GnRH) antagonist ovarian stimulation protocol on the outcome of IVF/ICSI regarding number of retrieved oocyte, oocyte maturation rate, fertilization rate, good quality embryo rate, cycle cancellation rate, pregnancy rate and clinical abortion rate. Subjects & Methods: A total of 84 patients, in a prospective controlled clinical trial, had ICSI using GnRH antagonist protocol during the period from February 1st, 2009 to September 30th, 2011 were included in this prospective randomized trial. We compared the IVF outcomes between OCP pretreated (n=43) and no pretreatment group (n=41) in gonadotropin-releasing hormone (GnRH) antagonist ovarian stimulation protocol. Results: The mean duration of ovarian stimulation and mean amount of gonadotropins in OCP pretreated group was significantly higher than that of no pretreatment group (11.7 ± 2.3 vs. 9.8 ± 1.8 days and 2720.4 ± 1165.0 IU vs. 2295.8 ± 1121.1 IU). The mean number of retrieved oocytes and oocyte maturation rate was significantly higher in OCP pretreated group (10.9 ± 5.3 vs. 7.5 ± 5.2 and 90.8% vs. 73.3%). The number of total gained embryos and the good quality embryo rate was also significantly higher in OCP pretreated group (7.9 ± 0.9 vs. 4.2 ± 1.0 and 69.9 % vs. 48.7%). Fertilization rate was also higher in OCP pretreated group (84.9 ± 0.2% vs. 70.5 ± 0.3%). The implantation and pregnancy rate were higher, although not reaching statistically significant level, in OCP pretreated group (11.6% vs. 10.7% and 45.4% vs. 36.2%). Conclusion: OCP pretreatment before GnRH antagonist protocol for IVF appears to have reliable benefits in terms of IVF outcomes regarding number of retrieved oocytes, oocyte maturation rate, fertilization rate, and good quality embryo rate. But, it also has a weak point in respect to longer stimulation duration and increased gonadotropin consumption. The OCP pretreated cycle in GnRH antagonist protocol is more advantageous, despite not reaching statistical significant level, in respect to pregnancy rate, and cycle cancellation rate. Well controlled, large scaled studies are needed to support effectiveness of OCP pretreatment before starting GnRH antagonist ovarian stimulation protocol for IVF/ICSI. | ||||
| Keywords | ||||
| Keywords: Gonadotropin-releasing hormone antagonist; Oral contraceptive pill pretreatment; Ovarian stimulation; In vitro Fertilization | ||||
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