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

Objective 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). Design Retrospective cohort study. Setting Reproductive center. Patients 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. Intervention(s) 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. Results 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). Conclusions Pretreatment OC use is associated with a reduction in fLBR and cLBR.