Abstract
Objectives: To evaluate different oral contraceptive pill (OCP) pretreatment associated differential in-vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) outcomes of polycystic ovary syndrome (PCOS) patients and explore enhanced hormonal balance induced by the pretreatment.
Methods: This retrospective study included 500 PCOS women and 565 normal ovulating counterparts undergoing IVF/ICSI. The PCOS patients were divided into three groups based on the OCP pretreatment regimens: non-OCP (without OCP pretreatment), unsuccessive OCP (the period of successive pretreatment ≤2 months) and successive OCP (the period of successive pretreatment ≥3 months) groups. Comprehensive hormonal and ultra-sonographic assessments were performed before/after IVF pretreatment. Confounding factors affecting pregnancy outcomes were analyzed with logistic regression.
Results: PCOS patients with significant endocrine disorders had reduced implantation and pregnancy rates and increased miscarriage rate. Successive, not unsuccessive OCP pretreatment, significantly improved the implantation and pregnancy rates, and reduced the incidence of monotocous small-for-gestational age infants, which was accompanied by remarkably decreased hyperandrogenism and antral follicles.
Conclusion: PCOS is an independent risk factor for poor IVF outcome. Successive, not unsuccessive, OCP cyclical pretreatment could improve pregnancy outcome of PCOS patients, associated with reduction of hyperandrogenism and antral follicle excess.
Declaration of interest
The authors declare that they have no competing interests. This study was funded by a research grant from National Basic Research Program of China (No. 2012CB944900 to H. F. H and No. 2011CB944502 to J. Z. S.); The National Science and Technology Support Program (No. 2012BAI32B01 to H. F. H.), Natural Science Foundation of China (No. 31171444 and 81450038 to H. F. H, No. 81270708 to J. Z. S., No. 81401167 to F. F. W.).
Supplementary material available online
Supplementary Figure 1 and Tables 1 and 2