Pretreatment with an oral contraceptive is effective in reducing the incidence of functional ovarian cyst formation during pituitary suppression by gonadotropin-releasing hormone analogues.

Abstract

PURPOSE:

Our purpose was to assess the effect of pretreatment with oral contraceptives (OCs) on the formation of functional ovarian cysts during pituitary suppression with gonadotropin-releasing hormone (GnRH) agonists, subsequent follicular development, and pregnancy rates.

METHODS:

A retrospective case-controlled study of 31 in vitro fertilization (IVF) patients, all of whom in a previous cycle had commenced the long protocol of GnRH-agonist (Buserelin) in the early follicular phase and were pretreated in a subsequent cycle with 2 weeks of an OC containing 30 micrograms of ethinyl estradiol and 150 micrograms of desogestrel prior to GnRH-agonist administration, was undertaken. Follow-up visits were arranged after a minimum of 11 days of GnRH-agonist administration and weekly thereafter until pituitary suppression was achieved.

RESULTS:

Cysts were detected in 16 (51.6%) of the 31 patients not pretreated with OCs, and in 0 (0%) of the 31 patients pretreated with OCs (odds ratio = 67.1; 95% confidence interval = 5.6-350.7). Patients pretreated with OCs achieved pituitary suppression more rapidly (median difference = 4 days; 95% confidence interval = 2-7) and had comparable gonadotropin requirements and pregnancy rates.

CONCLUSIONS:

Pretreatment with OCs prior to pituitary suppression in the early follicular phase decreases ovarian cyst formation, without an apparent effect on subsequent follicular recruitment or pregnancy rates.

• Authors: M M Biljan, N G Mahutte, N Dean, R Hemmings, F Bissonnette, S L Tan
• Journal: Journal of assisted reproduction and genetics (J Assist Reprod Genet) Vol. 15 Issue 10 Pg. 599-604 (Nov 1998) ISSN: 1058-0468 [Print] Netherlands
• PMID: 9866068 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Estradiol Congeners
• Fertility Agents, Female
• Progesterone Congeners
• Gonadotropin-Releasing Hormone
• Ethinyl Estradiol
• Menotropins
• Desogestrel
• Luteinizing Hormone
• Follicle Stimulating Hormone
• Buserelin

Topics

• Adult
• Buserelin (adverse effects)
• Case-Control Studies
• Desogestrel (administration & dosage, therapeutic use)
• Estradiol Congeners (administration & dosage, therapeutic use)
• Ethinyl Estradiol (administration & dosage, therapeutic use)
• Female
• Fertility Agents, Female (adverse effects)
• Fertilization in Vitro
• Follicle Stimulating Hormone (metabolism)
• Gonadotropin-Releasing Hormone (agonists)
• Humans
• Luteinizing Hormone (metabolism)
• Menotropins (therapeutic use)
• Ovarian Cysts (chemically induced, prevention & control)
• Ovarian Follicle (growth & development)
• Ovulation Induction
• Pituitary Gland, Anterior (drug effects, metabolism)
• Pregnancy
• Pregnancy Rate
• Premedication
• Progesterone Congeners (administration & dosage, therapeutic use)
• Retrospective Studies
• Secretory Rate (drug effects)