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

Song, Soo Youn; Yang, Jihyun; Song, Min; Oh, Hye Young; Lee, Geon Woo; Lee, Mina; Ko, Young Bok; Lee, Ki Hwan; Chang, Ha Kyun; Kwak, Sang Mi; Yoo, Heon Jong

doi:10.1007/s00404-019-05210-z

Cited by 7 publications

(4 citation statements)

References 21 publications

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“…Currently, symptomatic treatment dominates the clinical approach to PCOS and mainly includes the regulation of menstrual cycle, anti-hyperandrogenemia therapy, weight control, management of insulin resistance and metabolic disorders, and lifestyle modification ( 12-14 ). Drugs often used to reduce insulin resistance in obese patients with PCOS include metformin, glucagon-like peptide-1 (GLP-1) receptor agonists, and thiazolidinediones (TZDs) ( 7 ).…”

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confidence: 99%

Insulin Sensitizers for Improving the Endocrine and Metabolic Profile in Overweight Women With PCOS

Xing

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Objective To evaluate the efficacy of insulin sensitizers on menstrual frequency, sex hormone, and metabolic parameters in overweight women with polycystic ovary syndrome (PCOS). Methods We searched multiple databases from inception to September 2019 for randomized controlled trials. Network meta-analysis was conducted using multivariate random effects method. Results Fourteen trials reporting on 619 women were included. Compared with metformin, metformin + thiazolidinediones (TZDs) was more superior in menstrual recovery (weighted mean difference [WMD] 3.68; 95% credibility interval [CrI], 1.65 to 8.20), metformin + glucagon-like peptide-1 (GLP-1) receptor agonists was more effective in decreasing androstenedione (WMD −2.53; 95% CrI, −3.96 to −1.09), both metformin + GLP-1 receptor agonists (WMD 9.22; 95% CrI, 5.46 to 12.98) and metformin + TZDs (WMD 4.30; 95% CrI, 0.78 to 7.82) were more effective in increasing sex hormone–binding globulin (SHBG), while TZDs were less effective in decreasing body mass index (BMI) (WMD 1.69; 95% CrI, 0.72 to 2.66). Compared with GLP-1 receptor agonists, metformin + GLP-1 receptor agonists was associated with higher SHBG (WMD 7.80; 95% CrI, 4.75 to 10.85), lower free testosterone (WMD −1.77; 95% CrI, −3.25 to −0.29), lower androstenedione (WMD −2.70; 95% CrI, −3.91 to −1.50) and lower fasting blood glucose (WMD −0.41; 95% CrI, −0.73 to −0.08). Conclusion For overweight women with PCOS, both metformin combined with GLP-1 receptor agonists and metformin combined with TZDs appear superior to monotherapy in improving hyperandrogenemia. Metformin combined with TZDs could be particularly effective in promoting the recovery of menstruation. Metformin combined with GLP-1 receptor agonists has the additional advantage of improving fasting glucose when compared with GLP-1 receptor agonists alone. TZDs are inferior to metformin in decreasing BMI.

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confidence: 99%

Insulin Sensitizers for Improving the Endocrine and Metabolic Profile in Overweight Women With PCOS

Xing

2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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“…In addition, a higher number of mature oocytes was observed in the pretreatment group with natural E2 than in the group with the synthetic hormone when the analysis was controlled by the duration of COC use (6.28 vs 4.34; p = 0.014) [19]. The authors concluded that the natural estrogen in a COC, rather than being associated with deleterious embryological or clinical outcomes, significantly improved the number of embryos and top-quality embryos.…”

Section: Discussionmentioning

confidence: 96%

“…Microsoft® Excel 2016 was used to create the data extraction form and summarize the findings. The articles selected for the narrative review were the following: A randomized controlled trial conducted in Spain, A proof-of-concept study also carried out in Spain, An updated meta-analysis carried out in Germany, A randomized controlled trial conducted in China, A randomized control trial conducted in Iran, A meta-analysis conducted in the Republic of Korea, A retrospective study carried out in Spain, A cohort study carried out in Brazil [13][14][15][16][17][18][19][20].…”

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confidence: 99%

Hormonal Pretreatment for Ovarian Stimulation: A Narrative Review

Rosas¹

2023

J Gynecol Res Rev Rep

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Introduction: Assisted reproductive technologies are necessary and important for the management of infertility and can be applied with and without the use of strategies such as hormonal pretreatment. However, there is a discussion in the literature on whether hormonal pretreatment in ovarian stimulation protocols can improve the outcome of oocytes and embryos. This study aimed to conduct an integrative review of hormonal pretreatment and its impact on women undergoing assisted reproduction procedures. Methods: We made searches in the PubMed and the Cochrane Library databases. The inclusion criteria were articles published in peer-reviewed journals in English, Portuguese, or Spanish from January 1, 2010 to December 31, 2021 and available as free full texts. We excluded gray literature works, including term papers, theses, and dissertations. We used a narrative synthesis for data analysis. Results: The 189 articles retrieved from the two databases (2010-2021) were narrowed down to eight articles. In most studies, pretreatment seems to play a role beyond stimulation that includes an early inhibition of the FSH peak, a more homogeneous cohort, and better results. Conclusions: Using a pretreatment with combined oral contraceptives (COC) produces conflicting results in assisted reproduction. The COC improves the quantity and quality of eggs, but it neither benefits nor harms reproductive outcomes. Also, the use of COC has contradictory results regarding clinical pregnancy

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“…[5] In addition to being useful for cycle scheduling, pretreatment with COCs can help control follicular growth and minimize follicle development. [6] Nonetheless, studies on the impact of COCs on PCOS patient outcomes have shown contradictory findings. While some writers found no substantial benefit effects, others reported considerably higher clinical pregnancy rates and reduced OHSS rates.…”

Section: Study Interventions and Proceduresmentioning

confidence: 99%

The Effect of Normalization of FSH/LH Ratio on the Response to Induction of Ovulation and Pregnancy Rate in Polycystic Ovary Syndrome Patients

Moussa,

Shaaban,

Elfaissal

et al. 2024

Evidence Based Women's Health Journal

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

Cited by 7 publications

References 21 publications

Insulin Sensitizers for Improving the Endocrine and Metabolic Profile in Overweight Women With PCOS

Insulin Sensitizers for Improving the Endocrine and Metabolic Profile in Overweight Women With PCOS

Hormonal Pretreatment for Ovarian Stimulation: A Narrative Review

The Effect of Normalization of FSH/LH Ratio on the Response to Induction of Ovulation and Pregnancy Rate in Polycystic Ovary Syndrome Patients

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