IVI-Madrid, Rey Juan Carlos University, Madrid, Spain.
Fertil Steril. 2011 Sep;96(3):590-3. doi: 10.1016/j.fertnstert.2011.06.022. Epub 2011 Jun 30.
To compare cycle outcomes after scheduling with the standard long protocol versus the use of oral contraceptive pills (OCPs) in patients undergoing GnRH antagonist cycles.
Prospective, randomized, controlled trial.
University-affiliated private assisted reproduction center.
PATIENT(S): Regularly cycling women aged ≤38 years with fewer than three previous IVF attempts were enrolled. Previous low responses to controlled ovarian hyperstimulation, ovarian surgery, or polycystic ovary were exclusion criteria.
INTERVENTION(S): One hundred fifteen patients received OCP (0.030 ethinyl E(2)/0.15 desogestrel) for 12-16 days, and controlled ovarian hyperstimulation was started on day 5 after OCP treatment; similarly, 113 patients received the long protocol from day 20-22 of the previous cycle.
MAIN OUTCOME MEASURE(S): The primary outcome was ongoing pregnancy rate; secondary outcome variables were clinical pregnancy rate, live birth rate, implantation rate, and miscarriage rate.
RESULT(S): Patients receiving the GnRH antagonist treatment showed a lower peak serum E(2) (1,334 vs. 1,823 pg/mL) but similar peak serum PE (0.58 vs. 0.65 ng/mL), lower duration of the stimulation (10.3 vs. 11.4 days) with similar FSH consumption (1,613 vs. 1,807 IU), and ovarian response (10.2 vs. 11.7 oocytes). No differences were observed in the fertilization rates (68.1% vs. 64.8%), total number of embryos obtained (5.9 vs. 6.2), mean number of embryos transferred (1.8 vs. 1.8), implantation rate (36% vs. 39%), miscarriage rate (8.9% vs. 17%), ongoing pregnancy rate (47.8% vs. 53.9%), or live birth rate (44.3% vs. 47%).
CONCLUSION(S): Comparable outcomes can be obtained using OCP containing 0.030 ethinyl E(2)/0.15 desogestrel to schedule patients undergoing the antagonist protocol.
比较 GnRH 拮抗剂周期中使用避孕药（OC）与标准长方案对周期结局的影响。
前瞻性、随机、对照试验。
大学附属私立辅助生殖中心。
年龄≤38 岁、既往 IVF 尝试次数少于 3 次的规律排卵患者。既往卵巢低反应、卵巢手术或多囊卵巢病史为排除标准。
115 例患者口服 0.030 炔雌醇/0.15 去氧孕烯 OC 12-16 天，OC 治疗后第 5 天开始控制性卵巢刺激；113 例患者接受长方案，从上次周期第 20-22 天开始。
主要结局为持续妊娠率；次要结局变量为临床妊娠率、活产率、种植率和流产率。
接受 GnRH 拮抗剂治疗的患者血清 E2 峰值较低（1334 比 1823 pg/ml），但 PE 峰值相似（0.58 比 0.65 ng/ml），刺激持续时间较短（10.3 比 11.4 天），FSH 用量相似（1613 比 1807 IU），卵巢反应相似（10.2 比 11.7 个卵母细胞）。两组受精率（68.1%比 64.8%）、获卵总数（5.9 比 6.2）、平均移植胚胎数（1.8 比 1.8）、种植率（36%比 39%）、流产率（8.9%比 17%）、持续妊娠率（47.8%比 53.9%）和活产率（44.3%比 47.8%）差异均无统计学意义。
OC 方案（含 0.030 炔雌醇/0.15 去氧孕烯）可用于 GnRH 拮抗剂方案的患者，获得的结果相似。
