Effects of oral contraceptive, synthetic progestogen or natural estrogen pre-treatments on the hormonal profile and the antral follicle cohort before GnRH antagonist protocol
Open Access
- 26 August 2006
- journal article
- research article
- Published by Oxford University Press (OUP) in Human Reproduction
- Vol. 22 (1), 109-116
- https://doi.org/10.1093/humrep/del340
Abstract
BACKGROUND: Steroid pre-treatments may be useful to program GnRH antagonist IVF/ICSI cycles. This prospective study assessed hormonal and ultrasound data collected during the free period after the discontinuation of three different pre-treatments to provide information on the optimal time interval required before starting stimulation. METHODS: Women were randomized to receive oral contraceptive pill (OCP) [ethinyl estradiol (E2) 30 µg + desogestrel 150 µg] (n = 21) or norethisterone 10 mg/day (n = 23) or 17-βE2 4 mg/day (n = 25) or no pre-treatment (n = 24) for one cycle before IVF. Assessments were performed on post-treatment day (PD) 1, 3 and 5, or on spontaneous cycle day (CD) 1 and 3. RESULTS: After OCP and progestogen administration, FSH and LH concentrations shifted from strongly suppressed PD1 levels to PD5 values similar to those observed on CD1. Meanwhile, follicle sizes remained small up to PD5. In contrast, estrogen pre-treatment poorly reduced FSH levels on PD1 compared with OCP or progestogen. Consequently, follicle size was more heterogeneous. FSH rebound was maximal on PD3, whereas LH levels were slightly increased up to PD5. CONCLUSIONS: A 5-day free interval after OCP or progestogen offers the advantages of gonadotrophin recovery and homogeneous follicular cohort, whereas early FSH rebound occurring after estrogen pre-treatment argues for a short free period.Keywords
This publication has 26 references indexed in Scilit:
- Effect of oral contraceptive pill pretreatment on ongoing pregnancy rates in patients stimulated with GnRH antagonists and recombinant FSH for IVF. A randomized controlled trialHuman Reproduction, 2005
- A comparative randomized trial to assess the impact of oral contraceptive pretreatment on follicular growth and hormone profiles in GnRH antagonist-treated patientsHuman Reproduction, 2005
- Similar endometrial development in oocyte donors treated with either high- or standard-dose GnRH antagonist compared to treatment with a GnRH agonist or in natural cyclesHuman Reproduction, 2005
- A randomized prospective trial comparing gonadotropin-releasing hormone (GnRH) antagonist/recombinant follicle-stimulating hormone (rFSH) versus GnRH-agonist/rFSH in women pretreated with oral contraceptives before in vitro fertilizationFertility and Sterility, 2005
- Dose-finding study of daily GnRH antagonist for the prevention of premature LH surges in IVF/ICSI patients: optimal changes in LH and progesterone for clinical pregnancyHuman Reproduction, 2005
- Profound LH suppression after GnRH antagonist administration is associated with a significantly higher ongoing pregnancy rate in IVFHuman Reproduction, 2004
- Luteal estradiol pre-treatment coordinates follicular growth during controlled ovarian hyperstimulation with GnRH antagonistsHuman Reproduction, 2003
- Does anovulation induced by oral contraceptives favor pregnancy during the following two menstrual cycles?Fertility and Sterility, 2000
- Main inhibitor of follicle stimulating hormone in the lutealfollicular transition: inhibin A, oestradiol, or inhibin B?Human Reproduction, 1999
- NEVER ON A SUNDAY: PROGRAMMING FOR IVF-ET AND GIFTThe Lancet, 1987