Pretreatment with oral contraceptive pills does not influence the pregnancy rate in the long leuprolide acetate protocol.

Background: To analyze the influence of oral contraceptive pill (OCP) pretreatment in intracytoplasmic sperm injection cycles among normoresponders in whom leuprolide acetate is preferred for that kind of gonadotropin-releasing hormone agonist.

Methods: Between March 2001 and January 2010, a total of 821 cycles were pretreated with OCP in luteal-long leuprolide acetate in the IVF Center, Faculty of Medicine, University of Hacettepe. Of these, a total of 169 consecutive patients were selected for the final analyses according to the selection criteria (OCP group) and compared with 349 age-matched controls (Control group). The normoresponders were defined by the presence of 6-15 antral follicles in both ovaries.

Results: Female age, body mass index, duration of infertility and antral follicle count were similar among both groups. Although the total dose of FSH used and duration of stimulation were similar, the maximal serum estradiol concentrations were higher in the OCP group than in the Control group (2,630.3 ± 1,568.0 vs. 2,166.5 ± 1,259.7 pg/ml, p = 0.001). The mean numbers of metaphase-II oocytes were 11.0 ± 6.2 versus 9.4 ± 5.2 in the OCP and Control groups, respectively (p = 0.004). The mean number of available day 3 embryos having ≥7 blastomeres was also higher in the OCP group (4.4 ± 3.3 vs. 3.5 ± 3.1, p = 0.013). However, the embryo transfer cancellation rate was noted to be higher in the OCP group, which is mainly due to fertilization failure and arrest during embryogenesis (6.5 vs. 2.9%, p = 0.049). The clinical pregnancy (36.7 vs. 38.3%) and implantation rates (21.8 vs. 20.6%) were comparable.

Conclusion: These findings suggest that although pretreatment with an OCP might exaggerate ovarian response, the pregnancy rate does not fluctuate in leuprolide acetate cycles among normoresponders.