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Clinical Trial
. 1989 Jun;3(2):107-15.
doi: 10.3109/09513598909152457.

Programmed oocyte retrieval: clinical and biological effects of oral contraceptives administered before in vitro fertilization

S Mashiach  1 , J Dor, M Goldenberg, J Shalev, D Levran, E Rudak, L Nebel, B Goldman, J Blankstein, Z Ben-Rafael
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Free article
Clinical Trial

Programmed oocyte retrieval: clinical and biological effects of oral contraceptives administered before in vitro fertilization

S Mashiach et al. Gynecol Endocrinol. 1989 Jun.
Free article

Abstract

We have prospectively compared two regimens of suppression of the hypothalamic-pituitary-ovarian axis by oral contraceptives (OCs) for 15 or 30 days and two ovarian stimulation protocols. The latent phase, which represents a period of ovarian insensitivity, was prolonged and directly correlated to the duration of suppression. Thirty days' suppression, compared with 15 days', resulted in the cancellation of more cycles and a lower fertilization and pregnancy percentage. No significant increase in either serum progesterone or luteinizing hormone was noted in suppressed cycles. It is concluded that if programming is desired, OCs should be used for the shortest period possible. The variation in the length of the follicular phase indicates that there is a different 'fixed' day for retrieval for each suppression-stimulation protocol and this day should be established prospectively.

PIP: 2 oral contraceptive time courses for ovarian suppression and 2 ovarian stimulation protocols were compared to a control stimulation protocol, for oocyte retrieval before in vitro fertilization. 77 women with normal ovulatory cycles and infertility caused by tubal disease were grouped into 5 groups. 2 groups received Neogynon (50 mcg ethinyl estradiol and 35 mg levonorgestrel) for 15 days, 2 groups received Neogynon for 30 days, 2 groups were stimulated by clomiphene citrate 100 mg/day for 5 days and 2 ampules/day of human menopausal gonadotropin (hMG) from Cycle Day 8,2 groups were stimulated by 2 ampules/day of hMG and 2 ampules of pure FSH + hMG on Days 5 and 6. Control received clomiphene citrate 100 mg/day from Day 5 of the natural cycle and hMG 2 ampules/day from Day 8. hCG was given when serum estradiol levels rose above 400 pg/ml and 2 16-mm follicles were seen on ultrasound. Those treated with OC for 30 days had a prolonged latent phase of estradiol increase, lower baseline LH, fewer recovered and fertilized oocytes, more cancellations, and a lower pregnancy rate, 5.8%, compared to 33% in controls, and 34.7% in women suppressed for 15 days. It was concluded that 15 days of suppression by oral contraceptives was effective and produced acceptable pregnancy rates. The cancellation rate, normally due to premature LH surges, was not decreased by suppressing these patients with oral contraceptives, probably because the ovary was less sensitive to stimulation.

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