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A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients.
Hum Reprod. 2006 Jan; 21(1):95-103.HR

Abstract

BACKGROUND

This randomized controlled trial was designed to assess the impact of oral contraceptive (OC) scheduling with a GnRH antagonist (ganirelix) regimen on the ovarian response of women undergoing recombinant FSH (rFSH) stimulation for IVF, compared with a non-scheduled ganirelix regimen and a long GnRH agonist (nafarelin) protocol.

METHODS

A total of 110 women was treated with an OC and ganirelix, 111 with ganirelix alone and 111 with nafarelin. The OC (containing 30 microg ethinylestradiol/150 microg desogestrel) was taken for 14-28 days and stopped 2 days prior to the start of rFSH treatment. Primary efficiency parameters were the number of cumulus-oocyte complexes (per attempt) and the number of grade 1 or 2 embryos (per attempt).

RESULTS

In terms of follicular growth and hormone profiles, the OC-scheduled antagonist regimen mimicked the agonist regimen rather than the (non-scheduled) GnRH antagonist regimen. In the OC-scheduled GnRH antagonist group and the nafarelin group (versus the non-scheduled antagonist group), pituitary suppression was more profound at the start of stimulation (P < or = 0.001), there was a slower start of follicular growth (P < or = 0.001), longer stimulation was required (11.7 and 10.3 days respectively versus 9.4; P < or = 0.001), and more rFSH was used (2667 and 2222 IU versus 1966 IU; P < or = 0.001). In the three groups, the number of oocytes was similar (13.1, 12.9 and 11.5 respectively; not significant) as well as the number of good quality embryos (5.1, 5.7 and 5.0 respectively; not significant).

CONCLUSION

OC treatment prior to the rFSH/ganirelix regimen can be successfully applied to schedule patients, although more days of stimulation and more rFSH are required than with a non-scheduled GnRH antagonist regimen.

Authors+Show Affiliations

Monash IVF and Department of Obstetrics and Gynecology, Monash University, Monash Medical Centre, 246 Clayton Road, Clayton, VIC 3168, Australia. lukrombauts@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16253978

Citation

Rombauts, Luk, et al. "A Comparative Randomized Trial to Assess the Impact of Oral Contraceptive Pretreatment On Follicular Growth and Hormone Profiles in GnRH Antagonist-treated Patients." Human Reproduction (Oxford, England), vol. 21, no. 1, 2006, pp. 95-103.
Rombauts L, Healy D, Norman RJ, et al. A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients. Hum Reprod. 2006;21(1):95-103.
Rombauts, L., Healy, D., & Norman, R. J. (2006). A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients. Human Reproduction (Oxford, England), 21(1), 95-103.
Rombauts L, et al. A Comparative Randomized Trial to Assess the Impact of Oral Contraceptive Pretreatment On Follicular Growth and Hormone Profiles in GnRH Antagonist-treated Patients. Hum Reprod. 2006;21(1):95-103. PubMed PMID: 16253978.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients. AU - Rombauts,Luk, AU - Healy,David, AU - Norman,Rob J, AU - ,, Y1 - 2005/10/27/ PY - 2005/10/29/pubmed PY - 2006/2/28/medline PY - 2005/10/29/entrez SP - 95 EP - 103 JF - Human reproduction (Oxford, England) JO - Hum Reprod VL - 21 IS - 1 N2 - BACKGROUND: This randomized controlled trial was designed to assess the impact of oral contraceptive (OC) scheduling with a GnRH antagonist (ganirelix) regimen on the ovarian response of women undergoing recombinant FSH (rFSH) stimulation for IVF, compared with a non-scheduled ganirelix regimen and a long GnRH agonist (nafarelin) protocol. METHODS: A total of 110 women was treated with an OC and ganirelix, 111 with ganirelix alone and 111 with nafarelin. The OC (containing 30 microg ethinylestradiol/150 microg desogestrel) was taken for 14-28 days and stopped 2 days prior to the start of rFSH treatment. Primary efficiency parameters were the number of cumulus-oocyte complexes (per attempt) and the number of grade 1 or 2 embryos (per attempt). RESULTS: In terms of follicular growth and hormone profiles, the OC-scheduled antagonist regimen mimicked the agonist regimen rather than the (non-scheduled) GnRH antagonist regimen. In the OC-scheduled GnRH antagonist group and the nafarelin group (versus the non-scheduled antagonist group), pituitary suppression was more profound at the start of stimulation (P < or = 0.001), there was a slower start of follicular growth (P < or = 0.001), longer stimulation was required (11.7 and 10.3 days respectively versus 9.4; P < or = 0.001), and more rFSH was used (2667 and 2222 IU versus 1966 IU; P < or = 0.001). In the three groups, the number of oocytes was similar (13.1, 12.9 and 11.5 respectively; not significant) as well as the number of good quality embryos (5.1, 5.7 and 5.0 respectively; not significant). CONCLUSION: OC treatment prior to the rFSH/ganirelix regimen can be successfully applied to schedule patients, although more days of stimulation and more rFSH are required than with a non-scheduled GnRH antagonist regimen. SN - 0268-1161 UR - https://www.unboundmedicine.com/medline/citation/16253978/A_comparative_randomized_trial_to_assess_the_impact_of_oral_contraceptive_pretreatment_on_follicular_growth_and_hormone_profiles_in_GnRH_antagonist_treated_patients_ L2 - https://academic.oup.com/humrep/article-lookup/doi/10.1093/humrep/dei302 DB - PRIME DP - Unbound Medicine ER -