Effect of oral contraceptive pill pretreatment on the patients with poor ovarian response prior to controlled ovarian hyperstimulation

Objective To determine whether the use of oral contraceptive pill (OCP) pretreatment prior to gonadotropin-releasing hormone antagonist (GnRH-A) protocol would improve the outcome of poor ovarian responders. Methods Totally 559 poor ovarian responders undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) cycles in Department of Obstetrics and Gynecology, Peking University First Hospital from January 2013 to December 2017 were divided into two groups according to the history whether the patients had been treated with OCP before the ovulatory period (OCP group, n=161; control group, n=398). Clinical data of these 559 patients were retrospectively analyzed. Results The required ampoules (31.19±17.03) and the duration of gonadotropin [(8.64±2.92) d] were lower in patients pretreatment with OCP than that in patients of control group [38.96±13.92, P<0.001; (9.38±2.26) d, P=0.004]. The cycle cancelled rate in patients of the OCP group (14.91%) was also lower than in patients of control group (25.13%, P=0.008). The number of oocyte retrieval (3.74±1.31), the number of MII oocyte (3.00±1.12) and the live birth rate (26.28%) were significantly higher in patients pretreatment with OCP than in patients of control group (3.44±1.36, P=0.030; 2.74±1.26, P=0.030; 17.45%, P=0.033). All the differences were statistically significances. Conclusion OCP administered before IVF-ET/ICSI were shown to improve the effect of ovulation-promotive treatment and decrease the cycle cancelled rate in poor ovarian responders. Key words: Fertilization in vitro; Intracytoplasmic sperm injection; Poor ovarian response; Oral contraceptive pill