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Archives of Gynecology and Obstetrics

, Volume 300, Issue 3, pp 737–750 | Cite as

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

  • 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 YooEmail author
Gynecologic Endocrinology and Reproductive Medicine
  • 103 Downloads

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.

Keywords

Combined oral contraceptives Assisted reproductive technology Polycystic ovary syndrome 

Notes

Funding

This work was supported by a research fund of KMI (Korea Medical Institute).

Compliance with ethical standards

Conflicts of interest

The authors have no financial disclosures to declare and no conflicts of interest to report.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Patient anonymity was completely preserved and the unique nature of identifying patients was not included in this manuscript.

Informed consent

This study was based on retrospective review of published studies, it was not necessary to obtain informed consent from individual participants.

Supplementary material

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Supplementary file1 (DOCX 14 kb)
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Supplementary file2 (DOCX 16 kb)
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Supplementary file3 (DOCX 17 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Soo Youn Song
    • 1
    • 2
  • Jung Bo Yang
    • 1
    • 2
  • Min Soon Song
    • 1
    • 2
  • Hye Young Oh
    • 1
    • 2
  • Geon Woo Lee
    • 1
    • 2
  • Mina Lee
    • 1
    • 2
  • Young Bok Ko
    • 1
    • 2
  • Ki Hwan Lee
    • 1
    • 2
  • Ha Kyun Chang
    • 3
  • Sang Mi Kwak
    • 4
  • Heon Jong Yoo
    • 1
    • 2
    Email author
  1. 1.Department of Obstetrics and GynecologyChungnam National University HospitalDaejeonRepublic of Korea
  2. 2.Chungnam National University School of MedicineDaejeonRepublic of Korea
  3. 3.Center for Uterine CancerResearch Institute and Hospital, National Cancer CenterGoyangRepublic of Korea
  4. 4.Total Healthcare Center, Kangbuk Samsung Hospital, School of MedicineSungkyunkwan UniversitySeoulRepublic of Korea

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