Among women undergoing ovarian stimulation in antagonist protocols, combined oral contraceptive pill (COCP) pretreatment was associated with a lower rate of live birth or ongoing pregnancy than no pretreatment, according to a Cochrane review of 29 randomized controlled trials (RCTs) of hormonal pretreatment in 4,701 women undergoing assisted reproductive technology (ART). The review determined whether pretreatment with the COCP or with a progestogen or estrogen alone in ovarian stimulation protocols affects outcomes in subfertile couples undergoing ART. Findings included:
- COCP pretreatment was associated with a lower rate of live birth or ongoing pregnancy vs no pretreatment.
- There was insufficient evidence to determine whether rates of live birth or ongoing pregnancy were influenced by pretreatment with progestogens or estrogens, or by COCP pretreatment using other stimulation protocols.
- Overall, findings of adverse events were inconclusive, except that progesterone pretreatment may reduce the risk of ovarian cysts in agonist cycles, and COCP in antagonist cycles may reduce the risk of pregnancy loss vs no pretreatment.
Farquhar C, Rombauts L, Kremer JAM, Lethaby A, Ayeleke RO. Oral contraceptive pill, progestogen or oestrogen pretreatment for ovarian stimulation protocols for women undergoing assisted reproductive techniques. Cochrane Database of Systematic Reviews. 2017, Issue 5. Art. No.:CD006109. doi:10.1002/14651858.CD006109.pub3.