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Early pregnancy loss in women stimulated with gonadotropin-releasing hormone antagonist protocols according to oral contraceptive pill pretreatment.

Bellver J, Albert C, Labarta E, Pellicer A

Instituto Valenciano de Infertilidad, Universidad de Valencia, Valencia, Spain. jbellver@ivi.es <jbellver@ivi.es>

OBJECTIVE: To evaluate and compare the risk of early pregnancy loss in patients stimulated with GnRH antagonist protocols according to oral contraceptive pill (OCP) pretreatment. DESIGN: Retrospective case-control study. SETTING: Instituto Valenciano de Infertilidad. University of Valencia. Spain. PATIENT(S): One thousand five hundred thirty-nine patients, aged <36, stimulated with GnRH antagonists for IVF between January 1, 2000 and November 1, 2005. INTERVENTION(S): Reproductive outcome was compared based on the application (or not) of OCP pretreatment: 944 women were included in the OCP group and 595 in the non-OCP group. The Student's t test was used for statistics. MAIN OUTCOME MEASURE(S): Pregnancy, biochemical pregnancy, ectopic pregnancy, early clinical pregnancy loss, early pregnancy loss, and ongoing pregnancy rates. RESULT(S): No significant differences were observed in any of the outcome parameters. Early pregnancy loss rates were similar: 23% in the OCP pretreatment group versus 19.2% in the non-OCP pretreatment group. However, longer periods of ovarian stimulation and higher doses of gonadotropins needed to be employed in the OCP group. CONCLUSION(S): There is not sufficient evidence to confirm OCP pretreatment as a risk factor for miscarriage in patients stimulated with GnRH antagonist protocols.

Published 4 May 2007 in Fertil Steril, 87(5): 1098-101.
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