Optimization of Ovarian Stimulation After Preparation with Oral Hormonal Contraceptives

Abstract

Introduction: Ovarian stimulation can be performed in early follicular phase or after pretreatment with OCPs. The aim of this study is to know if OCPs prior to ovarian stimulation improve the results in an IVF cycle. Material and methods: Retrospective case-control study. We included 132 patients (aged 18-40 years) undergoing two consecutive IVF-ICSI cycles (264 cycles). One cycle was initiated without pretreatment and the other after pretreatment with dienogest 2 mg/etinylestradiol 0.03 mg. The dose and type of gonadotropins used was adjusted according to age, body mass index and antral follicle count. During ovarian stimulation, serial ultrasound and analytical controls were performed until the day of ovulation induction and puncture programming. Results: There were statistically significant differences in gestation rates with a higher number of pregnancies in the OCPs group (37.18% vs. 13.95%, p=0.005). The live newborn rate was higher in the group of patients prepared with OCPs (30.77% vs. 5.81%, p=0.005). Total days of stimulation was lower in the OCPs group (8.50 vs. 9.13, p=0.000). There were no statistically significant differences in the total number of oocytes retrieved, metaphase II oocytes or embryo quality. Conclusions: the use of OCPs can be considered as a pre-treatment in an IVF cycle since it allows us to plan ovarian stimulation without worsening the live birth rate.