Effect of pretreatment with oral contraceptives and progestins on IVF outcomes in women with polycystic ovary syndrome

作者：Daimin Wei, Yuhua Shi, Jing Li, Ze Wang, Lin Zhang, Yun Sun, Hong Zhou, Yuping Xu, Chunxiang Wu, Ling Liu, Qiongfang Wu, Lili Zhuang, Yanzhi Du, Weiping Li, Heping Zhang, Richard S. Legro, Zi‐Jiang Chen · 发表于：Human Reproduction · 年份：2016 · DOI：10.1093/humrep/dew325 · 被引用次数：58 · 研究领域：Ovarian function and disorders、Reproductive Health and Contraception、Reproductive Biology and Fertility

STUDY QUESTION: Do oral contraceptives (OCs) and progestins impact live birth rate of IVF when used for cycle scheduling in women with polycystic ovary syndrome (PCOS)? SUMMARY ANSWER: OCs used for scheduling IVF cycle were associated with lowered rates of pregnancy and live birth after fresh embryo transfer, whereas progestins used for this purpose yield higher rates of pregnancy and live birth than OCs. WHAT IS KNOWN ALREADY: Due to oligo-menorrhea in PCOS, OCs and progestin are extensively used to schedule the start of an IVF cycle in women with PCOS. Little is known about the effect of such pretreatments on outcomes, especially, the rate of live birth. STUDY DESIGN, SIZE, DURATION: This was a nested cohort study and secondary analysis of a multicenter randomized trial, which was designed to compare live birth rate after fresh embryo transfer vs frozen embryo transfer (FET) in women with PCOS (Frefro-PCOS). A total of 1508 women were enrolled from 14 centers between June 2013 and May 2014. PARTICIPANTS/MATERIALS, SETTING, METHODS: At the discretion of local investigators, subjects were instructed to wait for spontaneous menses (Control group, n = 323), or were prescribed progestins (P group, n = 283) or OCs (OCs group, n = 902) to induce menstruation prior to the start of ovarian stimulation. GnRH antagonist protocol was initiated at Day 2 or 3 of induced or spontaneous menses cycle. The rates of pregnancy, pregnancy loss and live birth after either fresh embryo transfer o...