First intention IVF protocol for polycystic ovaries: does oral contraceptive pill pretreatment influence COH outcome?

Reproductive Biology and Endocrinology

Didier Dewailly²  Brigitte Leroy-Martin¹  Valerie Lefebvre-Khalil¹  Benoit Soudan³  Catherine Lefebvre²  Maryse Leroy²  Patricia Thomas²  Geoffroy Robin²  Christine Decanter² 

[1] Institute of Reproductive Biology, Centre Hospitalier Régional et Universitaire CHRU, 59037, Lille Cedex, France;IVF center of Jeanne de Flandre Hospital, Department of Endocrine Gynaecology and Reproductive Medicine, Centre Hospitalier Régional et Universitaire CHRU, Rue Eugène Avinée, 59037, Lille Cedex, France;Center of Biology and Pathology, Centre Hospitalier Régional et Universitaire CHRU, 59037, Lille Cedex, France

关键词: Embryo;    Oocyte;    Rotterdam ultrasonographic criteria;    GnRH agonist;    COH outcome;    Pretreatment;    OCP;    IVF;    PCOS;    PCO;   

Others  :  826238
DOI  :  10.1186/1477-7827-11-54

 received in 2013-01-04, accepted in 2013-06-06,  发布年份 2013

【 摘 要 】

Background

Morphological aspect of polycystic ovaries (PCO) is a very common finding in an IVF center population: this includes PCOS patients identified in 18–25% of the couples presenting with infertility and so called “sonographic PCO only” the prevalence of which has been estimated as high as 33% in asymptomatic patients. Finding the optimal first intention IVF protocol for polycystic ovaries patients is still challenging in order to improve the controlled ovarian hyperstimulation (COH) outcome while avoiding ovarian hyperstimulation syndrome (OHSS). It has been suggested that women with PCO would benefit from a longer period of pituitary down-regulation. The purpose of this study was to compare an extended duration of OCP pretreatment with a classic GnRH agonist protocol.

Methods

A single center prospective non-randomized study was performed from January 2009 to December 2010 in the Lille University Hospital including 113 women diagnosed with PCO(S) according to the Rotterdam ultrasonographic criteria and undergoing their first IVF attempt. Comprehensive hormonal and ultra-sonographic assessments were collected during COH in these patients. LH and androgen suppression and dynamics of follicular growth were compared between the two protocols as well as the COH outcome in terms of oocyte/embryo number and quality, implantation and pregnancy rates.

Results

No significant difference was observed between the two groups concerning dynamics of follicular growth and hormonal values. Clinical and ongoing pregnancy rates were significantly lower in the OCP group despite same oocyte and embryo quality. Nevertheless, the cumulative pregnancy rate did not differ between the two groups. The incidence of OHSS was not statistically significant.

Conclusions

Extended duration of OCP pretreatment, as a first intention IVF protocol for PCO patients, does not improve the pattern of follicular growth nor the oocyte and embryo quality.

【 授权许可】

   
2013 Decanter et al.; licensee BioMed Central Ltd.

【 图 表 】

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