Clinical and Experimental Reproductive Medicine

The Korean Society for Reproductive Medicine (대한생식의학회)
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Pretreatment of normal responders in fresh in vitro fertilization cycles: A comparison of transdermal estradiol and oral contraceptive pills

  • Pereira, Nigel (Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center) ;
  • Petrini, Allison C. (Department of Obstetrics and Gynecology, Weill Cornell Medical College) ;
  • Zhou, Zhen N. (Department of Obstetrics and Gynecology, Weill Cornell Medical College) ;
  • Lekovich, Jovana P. (Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center) ;
  • Kligman, Isaac (Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center) ;
  • Rosenwaks, Zev (Ronald O. Perelman and Claudia Cohen Center for Reproductive Medicine, Weill Cornell Medical Center)
  • Received : 2016.10.16
  • Accepted : 2016.11.14
  • Published : 2016.12.31
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Abstract

Objective: The aim of this study was to investigate the impact of pretreatment with transdermal estradiol ($E_2$) compared to oral contraceptive pills (OCPs) on controlled ovarian stimulation (COS) response in normal responders undergoing fresh in vitro fertilization (IVF)-embryo transfer (ET) cycles. Methods: A retrospective cohort study was performed of normal responders undergoing fresh IVF-ET cycles who received pretreatment with transdermal $E_2$ versus OCPs prior to fresh IVF-ET. The total days of ovarian stimulation, total dosage of gonadotropins, total number of oocytes, and mature oocytes retrieved were noted. Pregnancy outcomes after ET were also recorded. Results: A total of 2,092 patients met the inclusion criteria: 1,057 and 1,035 patients in the transdermal $E_2$ and OCP groups, respectively. Patients in the OCP group had a longer duration of COS ($10.7{\pm}1.63days$, p< 0.01) than the $E_2$ group ($9.92{\pm}1.94days$). Patients in the OCP group also required higher cumulative doses of gonadotropins ($2,657.3{\pm}1,187.9IU$) than those in the $E_2$ group ($2,550.1{\pm}1,270.2IU$, p= 0.002). No statistically significant differences were found in the total and mature oocytes retrieved or in the rates of biochemical pregnancy, clinical pregnancy, spontaneous miscarriage, and live birth between the groups. Conclusion: Our findings suggest that compared to OCPs, pretreatment with transdermal $E_2$ is associated with a shorter duration of ovarian stimulation and lower gonadotropin utilization, without compromising the oocyte yield or pregnancy outcomes in normal-responder patients undergoing fresh IVF.

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