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Effect of oral contraceptive pretreatment on IVF outcomes in women with polycystic ovary syndrome using a long GnRH agonist protocol

Year: 2025

Type: article

Abstract: OBJECTIVE: To evaluate the effect of oral contraceptive (OC) pretreatment on in vitro fertilization (IVF) outcomes in women with polycystic ovary syndrome (PCOS) undergoing the GnRH agonist (GnRH-a) long protocol, compared with other ovarian stimulation protocols. METHODS: This retrospective study included 121 women with PCOS, diagnosed according to the Rotterdam criteria, who underwent IVF/intracytoplasmic sperm injection (IVF/ICSI) between January and September 2018 at Beijing Obstetrics and Gynecology Hospital. Patients were assigned to one of four protocols: the OC pretreatment + GnRH-a long protocol (three cycles of OC), the standard GnRH-a long protocol, the GnRH antagonist protocol, or the GnRH-a ultralong protocol. Ovarian stimulation characteristics, embryo development, and clinical outcomes were compared among the groups. RESULTS: The GnRH-a ultralong protocol required significantly higher total Gn doses and longer stimulation duration than the OC + GnRH-a long protocol. Compared with the standard GnRH-a long protocol, OC pretreatment showed trends toward lower rates of moderate-to-severe ovarian hyperstimulation syndrome (OHSS) and higher biochemical and clinical pregnancy rates, though these differences were not statistically significant. No significant differences were observed among the groups for the number of retrieved oocytes, mature oocytes, fertilized oocytes, or normally developing embryos. CONCLUSION: In PCOS patients, OC pretreatment showed trends toward higher pregnancy rates and lower OHSS, without adverse effects on clinical outcomes. These findings highlight a potentially promising approach, warranting confirmation in larger, high-quality randomized controlled trials.

Source: Gynecological Endocrinology

DOI: 10.1080/09513590.2025.2594876

Authors: Muqing Gu, Xiangyan Ruan, Yanqiu Li, Chanwei Jia, Yinmei Dai

Institutions: Capital Medical University, Beijing Obstetrics and Gynecology Hospital

Language: English

Topic: Ovarian function and disorders

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funder: Beijing Municipal Administration of Hospitals