EFFICIENCY OF USING COMBINED ORAL CONTRACEPTIVES, ESTRADIOL VALERATE, AND GONADOTROPIN-RELEASING HORMONE ANTAGONIST FOR THE PROGRAMMING OF IN VITRO FERTILIZATION CYCLES


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To study the efficiency of programming an induced cycle using combined oral contraceptives (COCs), estrogens, and gonadotropin-releasing hormone (GnRH) antagonists. Subjects and methods. The investigation was conducted in the period October 2012 to November 2014. It enrolled 135 women who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) programs at the Academician VI. Kulakov Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation. All the patients were divided into 3 groups according to their preliminary preparation. Forty- five patients received COCs (ethinyl estradiol 0.03 mg/desogestrel 0.15 mg) for 14 days on day 2 of their menstrual cycle as preliminary preparation. Further ovarian stimulation was initiated using the standard protocol on day 5 after COC discontinuation. Forty-five women received estrogens (estradiol valerate 4 mg/day) on day 25 of their previous cycle, which was discontinued a day before ovarian stimulation. Forty-five patients were given GnRH antagonists in the early follicular phase (on day 2 of the cycle), followed by switching to standard stimulation with gonadotropins according to the GnRH antagonist fixed protocol on day 5 of the cycle. Results. The number of preliminary preparation days is much more in Group 1 than that in Groups 2 and 3 (14.0+0, 5.3+0.9, and 1.8+1.1, respectively). The indicators of stimulation cycles were comparable in the three groups. The implantation rates were 19.2, 38.5, and 39.0%, respectively, which was statistically significant. The conception rates were 35.5, 44.4, and 55.6%, respectively (p>0.05). The rate of biochemical (15.0, 0, and 4.0%) and clinical (28.8, 33.4, and 40.0%)pregnancies and early reproductive losses (2.2, 4.4, and 8.8%, respectively) were comparable between the groups. Conclusion. All the three examined regimens of preliminary preparation for stimulation in the IVFprograms using GnRH antagonist protocols were effective in obtaining clinical results. The programs with preliminary preparation with estrogens and GnRH antagonists showed virtually identical values in the number of stimulation days, the summary dose of administered gonadotropins, and conception and embryo implantation rates. Meanwhile, preparation with GnRH antagonists turned out to be significantly more effective in having conception and embryo implantation rates than that with COCs.

Full Text

Restricted Access

About the authors

M. Ѵ MARTYNOVA

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: Martinova_m@bk.ru
graduate student Moscow 117997, Ac. Oparina str. 4, Russia

N. G MISHIEVA

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@mail.ru
MD, Senior researcher of l-st gynecology department. Moscow 117997, Ac. Oparina str. 4, Russia

L. A LEVKOV

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: l_levkov@oparina4.ru
MD, PhD, Head of Department Moscow 117997, Ac. Oparina str. 4, Russia

B. A MARTAZANOVA

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: bellamart88@mail.ru
graduate student Moscow 117997, Ac. Oparina str. 4, Russia

V. S LAPINA

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: vslapina89@Gmail.ru
graduate student Moscow 117997, Ac. Oparina str. 4, Russia

Kh. A BOGATYREVA

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: Eva-90-B@yandex.ru
graduate student Moscow 117997, Ac. Oparina str. 4, Russia

A. N ABUBAKIROV

Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: nondoc555@yahoo.com
PhD, Head of l-st gynecology department Moscow 117997, Ac. Oparina str. 4, Russia

References

  1. Huirne J.A., Homburg R., Lambalk C.B. Are GnRH antagonists comparable to agonists for use in IVF? Hum. Reprod. 2007; 22(11): 2805-13.
  2. Garcia-Velasco J.A., Bermejo A., Ruiz F., Martinez-Salazar Requena A., Pellicer A. Cycle scheduling with oral contraceptive pills in the GnRH antagonist protocol vs the long protocol: a randomized, controlled trial. Fertil. Steril. 2011; 96(3): 590-3.
  3. GrowD., KawwassJ.F, KulkarniA.D., Durant T, Jamieson D.J., Macaluso M. GnRH agonist and GnRH antagonist protocols: comparison of outcomes among good-prognosis patients using national surveillance data. Reprod. Biomed. Online. 2014; 29(3): 299-304.
  4. Orvieto R., Batrizjo R GnRH agonist versus GnRH antagonist in ovarian stimulation: an ongoing debate. Reprod. Biomed. Online. 2013; 26(1): 4-8.
  5. Copperman A.B., Benadiva C. Optimal usage of the GnRH antagonists: a review of the literature. Reprod. Biol. Endocrinol. 2013; 11:20.
  6. Hauzman E.E., Zapata A., Bermejo A., Iglesias C., Pellicer A., Garcia- Velasco J.A. Cycle scheduling for in vitro fertilization with oral contraceptive pills versus oral estradiol valerate: a randomized, controlled trial. Reprod. Biol. Endocrinol. 2013; 11: 96.
  7. Sobotka V, Streda RMardesic I, TosnerJ., HeracekJ. Steroids pretreatment in assisted reproduction cycles. J. Steroid Biochem. Mol. Biol. 2014; 139: 114-21.
  8. Gelbaya T.A., Kyrgiou M., Tsoumpou I., Nardo L.G. The use of estradiol for luteal phase support in in vitro fertilization/intracytoplasmic sperm injection cycles: a systematic review and meta-analysis. Fertil. Steril. 2008; 90(6): 2116-25.
  9. Younis J.S., Soltsman S., Izhaki I., Radin 0., Bar-Ami S., Ben-Ami M. Early and short follicular gonadotropin-releasing hormone antagonist supplementation improves the meiotic status and competence of retrieved oocytes in in vitro fertilization-embryo transfer cycles. Fertil. Steril. 2010; 94(4): 1350-5.
  10. Blockeel C., Riva A., De Vos M., Haentjens P, Devroey P Administration of a gonadotropin-releasing hormone antagonist during the 3 days before the initiation of the in vitro fertilization/intracytoplasmic sperm injection treatment cycle: impact on ovarian stimulation. A pilot study. Fertil. Steril. 2011; 95(5): 1714-9.
  11. Frydman RForman R., Rainhorn J.D., Belaisch-Allart JHazout A., Testart J. A new approach to follicular stimulation for in vitro fertilization: programmed oocyte retrieval. Fertil. Steril. 1986; 46(4): 657-62.
  12. Wardle P.G., Foster PA., Mitchell J.D., McLaughlin E.A., Williams J.A., Corrigan E. et al. Norethisterone treatment to control timing of IVF cycle. Hum. Reprod. 1986; 1(7): 455-7.
  13. Zorn J.R., Boyer P, Guichard A. Never on a Sunday: programming for IVF- ET and GIFT. Lancet. 1987; 1(8529): 385-6.
  14. GerliS.,RemohiJ.,PartrizioP.,BorreroC.,BalmacedaJ.P,SilberSJ.,AschR.H. Programming of ovarian stimulation with norethindrone acetate in IVF/GIFT cycles. Hum. Reprod. 1989; 4(7): 746-8.
  15. Kolibianakis E.M., Papanikolaou E.G., Camus M., Toumaye H., Van Steirteghem A.C., Devroey P Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trial. Hum. Reprod. 2006; 21(2): 352-7.
  16. Griesinger G., Venetis C.A., Marx T, Diedrich K., Tarlatzis B.C., Kolibianakis E.M. Oral contraceptive pill pretreatment in ovarian stimulation with GnRH antagonists for IVF: a systematic review and metaanalysis. Fertil. Steril. 2008; 90(4): 1055-63.
  17. Andersen A.N., Witjes H, Gordon K., Mannaerts B.; Xpect investigators. Predictive factors of ovarian response and clinical outcome after IVF/ ICSI following a rFSH/GnRH antagonist protocol with or without oral contraceptive pre-treatment. Hum. Reprod. 2011; 26(12): 3413-23.
  18. Bermejo A., Iglesias C., Ruiz-Alonso M., Blesa D., Simon C., Pellicer A., Garcia-Velasco J. The impact of using the combined oral contraceptive pill for cycle scheduling on gene expression related to endometrial receptivity. Hum. Reprod. 2014; 29(6): 1271-8.
  19. Rombauts L., Healy D., Norman R.J.; Orgalutran Scheduling Study Group. A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patients. Hum. Reprod. 2006; 21(1): 95-103.
  20. Griesinger G., Kolibianakis E.M., Venetis C., Diedrich K, Tarlatzis B. Oral contraceptive pretreatment significantly reduces ongoing pregnancy likelihood in gonadotropin-releasing hormone antagonist cycles: an updated meta-analysis. Fertil. Steril. 2010; 94(6): 2382-4.
  21. Fanchin R., Salomon L., Castelo-Branco A., Olivennes F, Frydman N., Frydman R. Luteal estradiol pre-treatment coordinates follicular growth during controlled ovarian hyperstimulation with GnRH antagonists. Hum. Reprod. 2003; 18(12): 2698-703.
  22. Cedrin-Durnerin I., Guivarc’h-Leveque A., Hugues J.N.; Groupe d’Etude en Medecine et Endocrinologie de la Reproduction. Pretreatment with estrogen does not affect IVF-ICSI cycle outcome compared with no pretreatment in GnRH antagonist protocol: a prospective randomized trial. Fertil. Steril. 2012; 97(6): 1359-64.
  23. Cedrin-Durnerin I., Bstandig B., Pameix I., Bied-Damon V, Avril C., Decanter C., Hugues J.N. Effects of oral contraceptive, synthetic progestogen or natural estrogen pre-treatments on the hormonal profile and the antral follicle cohort before GnRH antagonist protocol. Hum. Reprod. 2007; 22(1): 109-16.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies