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01-09-2019 | Ovarian Hyperstimulation Syndrome | Gynecologic Endocrinology and Reproductive Medicine

Effect of pretreatment with combined oral contraceptives on outcomes of assisted reproductive technology for women with polycystic ovary syndrome: a meta-analysis

Authors: Soo Youn Song, Jung Bo Yang, Min Soon Song, Hye Young Oh, Geon Woo Lee, Mina Lee, Young Bok Ko, Ki Hwan Lee, Ha Kyun Chang, Sang Mi Kwak, Heon Jong Yoo

Published in: Archives of Gynecology and Obstetrics | Issue 3/2019

Abstract

Objective

To evaluate the effect of pretreatment with combined oral contraceptives (COC) on outcomes in women with polycystic ovary syndrome (PCOS) who underwent assisted reproductive technology for subfertility.

Methods

Two authors independently searched MEDLINE, EMBASE, and the Cochran Library to identify and review articles published from October 1995 until December 2018 according to selection criteria. Outcomes are expressed as mean difference and odds ratio (OR) in a meta-analysis model.

Results

A total of seven studies were included in this meta-analysis: one randomized controlled study and two prospective and four retrospective cohort studies. Meta-analysis showed that the COC pretreatment did not affect rate of clinical pregnancy (OR = 0.93, 95% confidence interval CI 0.65–1.34, I² = 76%) or ovarian hyperstimulation syndrome (OR = 0.90, 95% CI 0.57–1.44, I² = 0%). However, the rate of miscarriage in the COC group was significantly higher (OR = 1.33, 95% CI 1.02–1.72, I² = 9%) and the rate of cumulative live birth was significantly lower compared with the control group (OR = 0.72, 95% CI 0.54–0.98, I² = 55%). Subgroup analysis showed higher rates of miscarriage and lower rates of cumulative live birth in studies with a gonadotropin-releasing hormone (GnRH) antagonist protocol (OR = 1.69, 95% CI 1.17–2.44, I² = 0% and OR = 0.38, 95% CI 0.29–0.50, respectively).

Conclusion

Pretreatment with COC in women with PCOS before assisted reproductive technology may have an adverse effect on clinical outcomes, especially with a GnRH antagonist protocol.

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Title: Effect of pretreatment with combined oral contraceptives on outcomes of assisted reproductive technology for women with polycystic ovary syndrome: a meta-analysis
Authors: Soo Youn Song
Jung Bo Yang
Min Soon Song
Hye Young Oh
Geon Woo Lee
Mina Lee
Young Bok Ko
Ki Hwan Lee
Ha Kyun Chang
Sang Mi Kwak
Heon Jong Yoo
Publication date: 01-09-2019
Publisher: Springer Berlin Heidelberg
Keywords: Ovarian Hyperstimulation Syndrome
Polycystic Ovary Syndrome
Miscarriage
Polycystic Ovary Syndrome
Published in: Archives of Gynecology and Obstetrics / Issue 3/2019
Print ISSN: 0932-0067
Electronic ISSN: 1432-0711
DOI: https://doi.org/10.1007/s00404-019-05210-z

At a glance: The STEP trials

Springer Medicine

Effect of pretreatment with combined oral contraceptives on outcomes of assisted reproductive technology for women with polycystic ovary syndrome: a meta-analysis

Abstract

Objective

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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