Effect of pretreatment oral contraceptives on fresh and cumulative live birth in vitro fertilization outcomes in ovulatory women

In vitro fertilization cycle synchronization using oral contraceptives is associated with a reduction in fresh and cumulative live births. Pros and cons of cycle scheduling with its use should be weighed.

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VOLUME 114, ISSUE 4, P779-786


Yao Lu, M.D., Yuan Wang, Ph.D., Ting Zhang, Ph.D., Guiquan Wang, M.D., Yaqiong He, Ph.D., Steven R. Lindheim, M.D., Zhangsheng Yu, Ph.D., and Yun Sun, M.D., Ph.D.



To evaluate the impact of oral contraceptives (OC) on live birth rate (LBR) following a fresh embryo transfer and cumulative live birth rate (cLBR) in normal ovulatory women undergoing in vitro fertilization (IVF).


Retrospective cohort study.


Reproductive center.


A total of 3,110 normo-ovulatory women aged 20–40 years undergoing IVF either using or not using OC pretreatment in their first autologous cycle.


Patients initiated gonadotropins for their IVF cycle either after a spontaneous menses or following OC pretreatment, which was at the discretion of the provider or according to patients preference.

Main Outcome Measure(s)

The primary outcomes were LBR after fresh transfer (fLBR) and cLBR.


fLBR was significantly lower in women using OC compared to those not (42.6% vs. 52.8%). Although LBR after frozen embryo transfer cycles were similar (42.7% vs. 41.1%), cLBR was significantly lower in women using OC (62.8% vs. 67.6%). Multivariate logistic and COX regression analysis adjusting for baseline characteristics demonstrated that IVF cycle synchronization with OC was significantly associated with a lower fLBR (adjusted odds ratio 0.73, 95% confidence interval 0.62−0.86) and cLBR (adjusted hazard ratio 0.89, 95% confidence interval 0.80−0.98).


Pretreatment OC use is associated with a reduction in fLBR and cLBR.

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.