Profound Pituitary Suppression Following Oral Contraceptive Pretreatment in Gonadotropin-releasing Hormone Antagonist Cycles Does Not Impact Outcome: A Retrospective Cohort StudyVela G1*, Ruman J1, Luna M2, Sandler B1,3 and Copperman AB3
- *Corresponding Author:
- Gerardo Vela
Hospital San José de Hermosillo
Blvd. José Maria Morelos y Pavón
No. 340, Col. Bachoco, 83148 Hermosillo
E-mail: [email protected]
Received date: March 28, 2017; Accepted date: May 04, 2017; Published date: May 11, 2017
Citation: Vela G, Ruman J, Luna M, Sandler B, Copperman AB (2017) Profound Pituitary Suppression Following Oral Contraceptive Pretreatment in Gonadotropinreleasing Hormone Antagonist Cycles Does Not Impact Outcome: A Retrospective Cohort Study. JFIV Reprod Med Genet 5:200. doi:10.4172/2375-4508.1000200
Copyright: © 2017 Vela G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: This retrospective study evaluated the effect of profound pituitary suppression with oral contraceptive pill (OCP) pretreatment in gonadotropin-releasing hormone (GnRH) antagonist cycles stimulated with recombinant follicle stimulating hormone plus highly purified human menopausal gonadotropin. Methods: The analysis included women aged 20-46 years (N=318) who utilized OCP pretreatment in a private academic in vitro fertilization center between January 2008 and January 2010. Patients were retrospectively divided based on endogenous luteinizing hormone (LH) level (≤ 1.5 [n=75] vs. >1.5 [n=243] mI U/mL) on stimulation day 1. Results: In the LH ≤ 1.5 and >1.5 mIU/mL groups, respectively, the mean number of stimulation days was 10.9 and 9.5 days (P<0.0001); mean total gonadotropin use was 4,328 and 3,543 IU (P<0.0001). Oocyte retrieval was greater in the LH ≤ 1.5 versus >1.5 mIU/mL group (17.7 vs. 14.9 oocytes; P=0.02). Pregnancy outcomes were similar between groups. Longer OCP duration correlated with lower day 1 LH levels (r=–0.161, P=0.007). Greater LH suppression correlated with increased total gonadotropin dose (r=–0.227, P<0.001) and days of stimulation (r=–0.445, P<0.001). Conclusion: Women with profound LH suppression following OCP pretreatment demonstrated comparable prognosis compared with women without profound LH suppression, despite requiring longer stimulations and a higher total gonadotropin dose.