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
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
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DOI：
10.1093/humrep/dei348
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发表时间：
2006-02-01
影响因子：
6.1
通讯作者：
Devroey, P
中科院分区：
文献类型：
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作者：
Kolibianakis, EM;Papanikolaou, EG;Devroey, P
背景技术背景：这项随机对照试验的目的是评估口服避孕药（OCP）预处理对接受GnRH拮抗剂治疗的IVF患者继续妊娠概率的影响。方法：425例患者在月经周期第2天（非OCP组：n = 211）或停用OCP后5天（OCP组：n = 214）开始使用固定剂量的200 IU重组FSH（rFSH）。促性腺激素释放激素拮抗剂在刺激的第6天开始，用10，000 IU的HCG触发最终的卵母细胞成熟。研究结果：非OCP组和OCP组每个开始周期的持续妊娠率分别为27.5%和22.9%[差异的95%置信区间（CI）：-3.7至+12.8]。与非OCP组（21.6%）相比，OCP组（36.4%）的妊娠丢失率显着增加（差异的95%CI：-28.4至-2.3）。结论：与接受GnRH拮抗剂和重组FSH治疗的患者在周期第2天开始刺激相比，OCP预治疗似乎与每个开始周期的持续妊娠率无显著差异相关，并导致显着较高的早期妊娠丢失。
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.