Does hormonal contraception prior to in vitro fertilization (IVF) negatively affect oocyte yields? - A pilot study

Reproductive Biology and Endocrinology

Research

Hala Kubba¹  Ann Kim¹  David H Barad²  Norbert Gleicher²  Andrea Weghofer³ 

[1] Center for Human Reproduction, New York, NY, USA;Center for Human Reproduction, New York, NY, USA;Foundation for Reproductive Medicine, New York, NY, USA;Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University Vienna, Vienna, Austria;

关键词: Oral contraceptives;    Hormonal contraception;    In vitro fertilization (IVF);    Oocyte yield;    Ovarian reserve;    Androgens;   

DOI  :  10.1186/1477-7827-11-28

 received in 2013-01-31, accepted in 2013-03-13,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAs oral contraceptives (OCs) suppress anti-Müllerian hormone (AMH), and hormonal contraceptives (HCs), likely, suppress functional ovarian reserve, this study was initiated to determine whether HC affect oocyte yields.MethodsWe investigated in a retrospective cohort study 43 oocyte donors in 71 in vitro fertilization (IVF) cycles, evaluating anti-Müllerian hormone (AMH) and oocyte yields as reflections of functional ovarian reserve (OR). In 25 IVF cycles egg donors were on HC within one month prior to IVF, and in 46 cycles they were not. Donors, based on their HCs, were further subdivided into 12 with less, and 13 with more androgenic progestins.ResultsWhile the three groups did not differ in age, age at menarche, BMI and AMH, oocyte yields among donors who utilized estrane- and gonane-derived (higher androgenic) HCs were lower 11.3 (95% CI 8.3 – 14.3) than either donors using no HCs 16.6 (95% CI 14.7 -18.4) (P < 0.05) or those using anti-androgenic HCs 19.0 (95% CI 12.2-25.8) (P< 0.01). Significance was maintained after adjustments for the donor age and total FSH dose used in ovulation induction.ConclusionsEven in young oocyte donors, high androgenic OC exposure appears to suppress functional ovarian reserve and oocyte yields. Since OCs are often routinely used in preparation for IVF, such practice may require reevaluation. Especially in women with diminished ovarian reserve OCs, and especially high androgenic progestin HCs, should, likely, be avoided.

【 授权许可】

CC BY   
© Barad et al.; licensee BioMed Central Ltd. 2013