Effects of oral contraceptive pretreatment on IVF outcomes in women following a GnRH agonist protocol

RESEARCH QUESTION

Does oral contraceptive pretreatment impact IVF-embryo transfer cycle outcomes in women following the gonadotrophin-releasing hormone agonist (GnRHa) protocol?

DESIGN

This retrospective study was designed to compare cycle outcomes after oral contraceptive pretreatment versus the standard protocol in women within the GnRHa long protocol or the GnRHa short protocol. A total of 2052 women undergoing their first IVF treatment with the GnRHa long protocol and 3557 women with the GnRHa short protocol between 2012 and 2017 were enrolled.

RESULTS

No significant differences in the rates of clinical pregnancy (long protocol: 49.2% versus 46.7%; short protocol: 39.4% versus 38.0%) or live birth (long protocol: 44.3% versus 41.3%; short protocol: 32.8% versus 31.4%) after fresh embryo transfer were observed between the oral contraceptive group and the control group in either the long protocol or the short protocol.

CONCLUSIONS

Oral contraceptive pretreatment has no effect on IVF outcomes in either the GnRHa long protocol or short protocol.

Analysis of embryo quality with luteal phase ovarian stimulation after failed in vitro fertilization-embryo transfer with long or ultra-long protocol

OBJECTIVE

To investigate the effect of luteal phase ovarian stimulation on embryo quality after failed in vitro fertilization-embryo transfer with long or ultra-long protocol.

METHODS

In patients who underwent luteal phase ovarian stimulation after failed in vitro fertilization-embryo transfer with long or ultra-long protocol in the reproductive center between January 2015 and October 2017, self-control observations and statistical analyses were carried out for the number of oocytes retrieved, the rate of fertilization, the rate of D3 high-quality embryos, the rate of transplantable blastocyst formation, and the pregnancy rate of transfer cycle between long or ultra-long protocol and luteal phase ovarian stimulation.

RESULTS

The rate of fertilization and blastocyst were significantly increased after luteal phase ovarian stimulation (P < 0.05). However, the difference of the number of oocytes retrieved and the rate of D3 high-quality embryos was not statistically significant (p > 0.05).

CONCLUSIONS

The patients who failed with long protocol or ultra-long protocol due to low quality embryos, the protocol changed over to luteal phase ovarian stimulation. Can significantly improve the rate of fertilization oocytes and the transplantable blastocyst, and improve the outcome of clinical pregnancy. It provides an alternative ovarian stimulation protocol in patients with IVF-ET failure.

Cryopreserved embryo transfer: adjacent or non-adjacent to failed fresh long GnRH-agonist protocol IVF cycle

The optimal time to perform cryopreserved embryo transfer (CET) after a failed oocyte retrieval-embryo transfer (OR-ET) cycle is unknown. Similar clinical pregnancy rates were recently reported in immediate and delayed CET, performed after failed fresh OR-ET, in cycles with the gonadotrophin-releasing hormone (GnRH) antagonist protocol. This study compared outcomes of CET performed adjacently (<50 days, n = 67) and non-adjacently (≥50 to 120 days, n = 62) to the last OR-day of cycles with the GnRH agonist down-regulation protocol. Additional inclusion criteria were patients' age 20-38 years, the transfer of only 1-2 cryopreserved embryos, one treatment cycle per patient and artificial preparation for CET. Significantly higher implantation, clinical pregnancy and live birth rates were found in the non-adjacent group than in the adjacent group: 30.5% versus 11.3% (P = 0.001), 41.9% versus 17.9% (P = 0.003) and 32.3% versus 13.4% (P = 0.01), respectively. These results support the postponement of CET after a failed OR-ET for at least one menstrual cycle, when a preceding long GnRH-agonist protocol is used.