Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation

IF 3.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
Carlos Hernandez-Nieto , Saher Siddiqui , Loreli Mejia-Fernandez , Tamar Alkon-Meadows , Joseph Lee , Richard Slifkin , Tanmoy Mukherjee , Alan B. Copperman
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Abstract

Research question

Do the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)?

Design

This retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus–oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts.

Results

A total of 4059 oocyte freezing cycles were included in the analysis. Eight types of contraceptive method were recognized in patients undergoing ovarian stimulation: intrauterine device (IUD), copper (n = 84); IUD, levonorgestrel low dose (<52 mg) (n = 37); IUD, levonorgestrel (n = 192); subdermal etonogestrel implant (n = 14); injectable medroxyprogesterone acetate (n = 11); etonogestrel vaginal ring (n = 142); combined oral contraceptive pills (n = 2349); and norelgestromin transdermal patch (n = 10). The control group included patients not using contraceptives or using barrier or calendar methods (n = 1220). Among all the cohorts the median number of cumulus–oocyte complexes retrieved during oocyte retrieval was comparable (P = 0.054), and a significant difference in oocyte maturity rate with median number of vitrified oocytes was found (P = 0.03, P < 0.001, respectively). After adjusting for confounders a multivariate analysis found no association between the type of contraceptive and proportion of metaphase II oocytes available for cryopreservation.

Conclusions

Among the various forms of contraception, none was shown to have an adverse association with oocyte yield or maturation rate in patients undergoing POC.

各种避孕药对计划进行卵母细胞冷冻保存的患者的卵母细胞产量和成熟度的影响:一项回顾性队列研究
研究问题在接受计划性卵母细胞冷冻保存(POC)的患者中,各种形式的激素和非激素类避孕药与卵巢刺激结果(如卵母细胞产量和成熟度)是否有关联? 设计这项回顾性队列研究纳入了 2011 年至 2023 年期间接受 POC 周期的所有患者。研究记录了 POC 周期前使用的避孕药具类型。研究评估了阴道取卵后获得的卵母细胞-卵母细胞复合体的中位数,以及所有队列中进行玻璃化处理的分裂期 II 卵母细胞的比例。结果共有 4059 个卵母细胞冷冻周期纳入分析。在接受卵巢刺激的患者中,有八种避孕方法得到认可:铜宫内节育器(84 例);左炔诺孕酮低剂量宫内节育器(52 毫克)(37 例);左炔诺孕酮宫内节育器(192 例);皮下伊托诺孕酮植入(14 例);注射用醋酸甲羟孕酮(n = 11);依托孕烯阴道环(n = 142);复方口服避孕药(n = 2349);炔诺酮透皮贴片(n = 10)。对照组包括未使用避孕药具或使用屏障法或日历法的患者(n = 1220)。在所有组别中,取卵过程中取回的积液-卵母细胞复合体的中位数相当(P = 0.054),而卵母细胞成熟率与玻璃化卵母细胞中位数存在显著差异(分别为 P = 0.03、P < 0.001)。在对混杂因素进行调整后,一项多变量分析发现,避孕药具类型与可用于冷冻保存的分裂期 II 卵母细胞比例之间没有关联。
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来源期刊
Reproductive biomedicine online
Reproductive biomedicine online 医学-妇产科学
CiteScore
7.20
自引率
7.50%
发文量
391
审稿时长
50 days
期刊介绍: Reproductive BioMedicine Online covers the formation, growth and differentiation of the human embryo. It is intended to bring to public attention new research on biological and clinical research on human reproduction and the human embryo including relevant studies on animals. It is published by a group of scientists and clinicians working in these fields of study. Its audience comprises researchers, clinicians, practitioners, academics and patients. Context: The period of human embryonic growth covered is between the formation of the primordial germ cells in the fetus until mid-pregnancy. High quality research on lower animals is included if it helps to clarify the human situation. Studies progressing to birth and later are published if they have a direct bearing on events in the earlier stages of pregnancy.
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