The efficacy of oral contraceptive pre-treatment in controlled ovarian hyperstimulation using a GnRH antagonist in low responders.
- Author:
Jeong Won CHOI
1
;
Chung Hoon KIM
;
Hyang Ah LEE
;
Seok Ho HONG
;
Hee Young NAH
;
Young Jin LEE
;
Sung Hoon KIM
;
Hee Dong CHAE
;
Young Soo SON
;
Byung Moon KANG
Author Information
1. Department of Obstetrics and Gynecology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea. chnkim@amc.seoul.kr
- Publication Type:Original Article ; Randomized Controlled Trial
- Keywords:
Low responders;
GnRH antagonist;
Controlled ovarian hyperstimulation;
Oral contraceptive;
IVF
- MeSH:
Abortion, Spontaneous;
Embryonic Structures;
Female;
Fertilization;
Follicle Stimulating Hormone, Human;
Gonadotropin-Releasing Hormone*;
Humans;
Oocytes;
Ovulation Induction;
Pregnancy;
Pregnancy Rate;
Pregnancy, Multiple;
Prospective Studies
- From:Korean Journal of Obstetrics and Gynecology
2005;48(4):987-995
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: This study was performed to evaluate the efficacy of GnRH antagonist multidose protocol (GnRH-ant MDP) with or without oral contraceptive (OC) pretreatment in low responders undergoing IVF-ET, compared with standard GnRH agonist (GnRH-a) lowdose long protocol (LP). METHODS: Eighty-two patients, aged 28-42 years who were defined as low responders were recruited for this prospective study and they were randomized to undergo GnRH-ant MDP after OC pretreatment (group 1) or GnRH-ant MDP without OC pretreatment (group 2) or GnRH-a luteal lowdose LP (group 3). All of the subjects were administered recombinant human FSH (rhFSH) for ovarian stimulation. RESULTS: Patients' characteristics were comparable among three groups. Total dose and duration of rhFSH used for COH were significantly higher in group 3 than those in group 1 or 2. The number of mature oocytes, fertilization rate and the number of grade I, II embryos were significantly lower in group 2 than those in other groups. The clinical pregnancy rate seemed to be lower in group 2 but the difference did not achieve statistical significance. There were also no differences in the miscarriage rate and multiple pregnancy rate among three groups. CONCLUSION: This study demonstrates that GnRH-ant MDP with OC pretreatment is as effective as GnRH-a lowdose LP and might be considered more advantageous because of the short-term and small dose application in low responders.
