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Should we still advise infertile couples to use (barrier) contraception before IVF down-regulation?
P Platteau1, M Gabbe, M Famelos
1Monash-IVF, Epworth Hospital, Melbourne, Victoria, Australia. peter.plateau@az.vub.ac.be
Objective:
To determine the outcome of spontaneous conceptions in women who received GnRH agonists during mid-luteal phase down-regulation before IVF treatment.
Design:
Retrospective analysis of case records and study of the literature.
Setting:
Two university-affiliated reproductive medicine units.
Patient(S):
Seventy-three women who conceived spontaneously after starting down-regulation with a GnRH agonist before controlled ovarian hyperstimulation.
Intervention(S):
None.
Main Outcome Measure(S):
Course and clinical outcome of pregnancies.
Result(S):
Seventy-four pregnancies occurred in 73 women who received a GnRH agonist. Of these patients, 6 (8%) had a biochemical pregnancy, 6 (8%) had an ectopic pregnancy, 21 (28%) miscarried, and 41 pregnancies resulted in successfully delivered babies; there were 2 cases of congenital abnormalities.
Conclusion(S):
These cases, together with other published data, suggest that pregnancy outcome is not adversely affected by exposure to GnRH agonist during luteal-phase down-regulation. A central register of pregnant women who received a GnRH agonist is needed.