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Cycle scheduling with oral contraceptive pills in the GnRH antagonist protocol vs the long protocol: a randomized, controlled trial.
MedLine Citation:
PMID:  21718992     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To compare cycle outcomes after scheduling with the standard long protocol versus the use of oral contraceptive pills (OCPs) in patients undergoing GnRH antagonist cycles. DESIGN: Prospective, randomized, controlled trial. SETTING: University-affiliated private assisted reproduction center. PATIENT(S): Regularly cycling women aged ≤38 years with fewer than three previous IVF attempts were enrolled. Previous low responses to controlled ovarian hyperstimulation, ovarian surgery, or polycystic ovary were exclusion criteria. INTERVENTION(S): One hundred fifteen patients received OCP (0.030 ethinyl E(2)/0.15 desogestrel) for 12-16 days, and controlled ovarian hyperstimulation was started on day 5 after OCP treatment; similarly, 113 patients received the long protocol from day 20-22 of the previous cycle. MAIN OUTCOME MEASURE(S): The primary outcome was ongoing pregnancy rate; secondary outcome variables were clinical pregnancy rate, live birth rate, implantation rate, and miscarriage rate. RESULT(S): Patients receiving the GnRH antagonist treatment showed a lower peak serum E(2) (1,334 vs. 1,823 pg/mL) but similar peak serum PE (0.58 vs. 0.65 ng/mL), lower duration of the stimulation (10.3 vs. 11.4 days) with similar FSH consumption (1,613 vs. 1,807 IU), and ovarian response (10.2 vs. 11.7 oocytes). No differences were observed in the fertilization rates (68.1% vs. 64.8%), total number of embryos obtained (5.9 vs. 6.2), mean number of embryos transferred (1.8 vs. 1.8), implantation rate (36% vs. 39%), miscarriage rate (8.9% vs. 17%), ongoing pregnancy rate (47.8% vs. 53.9%), or live birth rate (44.3% vs. 47%). CONCLUSION(S): Comparable outcomes can be obtained using OCP containing 0.030 ethinyl E(2)/0.15 desogestrel to schedule patients undergoing the antagonist protocol.
Authors:
Juan A Garcia-Velasco; Alfonso Bermejo; Francisco Ruiz; Javier Martinez-Salazar; Antonio Requena; Antonio Pellicer
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-6-28
Journal Detail:
Title:  Fertility and sterility     Volume:  -     ISSN:  1556-5653     ISO Abbreviation:  -     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-7-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372772     Medline TA:  Fertil Steril     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
Affiliation:
IVI-Madrid, Rey Juan Carlos University, Madrid, Spain.
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