The Advantages And Disadvantages Of Oral Contraceptive Pill Pretreatment In In Vitro Fertilization And Embryo Transfer

Objective:To evaluate the advantagages and disadvantages of oral contracetive pill pretreatment in in vitro fertilization and embryo transfer, and to provide evidence-based basis for rational drug use.Methods:341 patients were divided into the OCP group (182 cases) and the controal group(159 cases) according to whether or not OCP was used before IVF-ET cycles, each group was divided into the IVF normal ovarian reaction subgroup, the IVF high ovarian reaction subgroup, the ICSI normal ovarian reaction subgroup and the ICSI high ovarian reaction subgroup according the fertilization way and the ovarian reaction. A retrospective analysis of the laboratory and clinical data was carried out for the assessment of the ovulation promoting effect of OCP and its influence on the IVF-ET.Results:The serum LH level was significantly lower in the OCP group than that in the control group at the COS start day and the hCG injection day (p<0.05), there were on obvious difference in the serum FSH, E2 level at the COS start day, in the serum E2, P level at the hCG injection day, and in the serum E2, P level at the embryo transfer day between the OCP group and the control group(P>0.05). The incidence of the functional ovarian cyst was decreased in OCP group compaired with the control group after the pituitary down-regulation(P<0.05). The volume and quantity of the antral follicle were lesser in OCP group than that in the control group at the COS start day(P<0.05). The average speed that the antral follicle grew to 14mm diameter from the COS start day was slower in the OCP group than that in the control group(P<0.05), but the average speed that the dominant follicle grew to the mature follicle was faster than that in the control group(P<0.05). There was a significantly reduction in the normal fertilization rate and the incidence of the moderate and severe OHSS(P<0.05). No significant differences were observed in the duration time from the pituitary down-regulating to the COS start day, the duration time and total quantity of using Gn, the endometria thinkness at hCG injection day, the total number of follicle, the ratio of follicle greater than 14mm diameter, the oocyte retrieval rate, the mature oocytr rate, the cleavage rate, the good quality embryo rate, the IVF cycle cancellation rate, the embryo implantation rate, the clinical pregnancy rate, the incidence of miscarriage etc(P>0.05). The normal fertilization rate in IFV way was decreased in the OCP group compared with the control group regardless of ovarian reaction was normal or not(P<0.05), but there was no difference in the normal fertilization rate in ICSI way between the OCP group and the normal control group(P>0.05).Conclusion:Oral contraceptive pill pretreatment may decrease the formation of functional ovarian cyst and the incidence of the moderate and severe OHSS before IVF-ET, but not improve the synchronization of follicle development and the pregnancy outcomes. Oral contraceptive pill pretreatment may decrease the serum LH level and the number of the antral follicle at the COS start day, and may reduce the development speed of the follicle in early and middle stage, so should duly adjust the types and dosage of Gn, and should avoid the adverse effect on the normal fertilizationin.