ABSTRACT
Background: both oral contraceptive pills [OCPs] and estradiol valerate [E2] have been used to schedule a gonadotropin-releasing hormone antagonist in vitro fertilization [IVF] cycles. Since the suppression of follicle-stimulating hormone by OCPs can stay 5-7 days after stopping the pills, it seems that starting the gonadotropin-releasing hormone [GnRH] after 6 days of pre-treatment discontinuation may be important in IVF outcomes
Objective: the aim of the present study was to determine the number of mature oocyte and pregnancy rate of three pretreatment methods for fresh embryo transfer cycles
Materials and Methods: in this randomized controlled trial, two-hundred ten women [18-35 yr and less than 2 previous IVF attempts] undergoing IVF with the GnRH antagonist protocol were randomized to the OCP, E2, and no pretreatment arms. OCP group [n=53] received OCP [ethinyl estradiol30 micro g and levonorgestrel150 micro g], E2 group [n=63] received 4 mg/day oral E2 [17beta?E2] for 10 days from day 20 of the previous cycle and GnRH antagonist stimulation was started 6 days after the interruption of OCP and E2. The control group [n =70] did not receive any pretreatment
Results: no significant difference was observed in the mean number of the mature oocyte, endometrial thickness, and embryo quality. The pregnancy rate in E2 group was higher than the two other groups [42.9% vs 39.6% and 34.3% in OCP and control group, respectively], but the difference was not statistically significant [p=0.59]
Conclusion: it seems OCP or E2 pretreatment could not improve the fresh IVF-embryo transfer outcomes