SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Reproduction
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1545508
Effect of pre-treatment with oral short-acting contraceptives on assisted reproductive technology outcomes in patients with polycystic ovary syndrome: a meta-analysis
Provisionally accepted
- Huzhou Maternity and Child Health Care Hospital, Huzhou, China
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Objective: This study aims to investigate the effects of pre-treatment with Combined Oral Contraceptives (COC) on the prognosis of individuals with polycystic ovary syndrome (PCOS) who undergo assisted reproductive technology (ART).Methods: Three databases (PubMed, Embase, and Cochrane Library) were searched from their establishment until February 23, 2024. Literature screening was performed based on predefined inclusion and exclusion criteria. Meta-analysis was executed using Stata 14.0 software, with outcomes expressed as mean differences (MD) and odds ratios (ORs), with 95% confidence intervals (CIs). Results: Our comprehensive analysis comprised of 11 studies, encompassing a total of 4413 patients diagnosed with PCOS. Meta-analysis results revealed that, compared to no pre-treatment, the use of COC pre-treatment did not significantly improve clinical pregnancy rates (OR: 0.96, 95% CI: 0.85 to 1.09), cumulative pregnancy rates (OR: 1.13, 95% CI: 0.92 to 1.39), or implantation rates (OR: 1.16, 95% CI: 0.99 to 1.36). However, the use of COC pre-treatment was found to be linked to a higher rate of miscarriage (OR: 1.29, 95% CI: 1.01 to 1.65). Additionally, it did not have a significant impact on the rate of live births (OR: 0.81, 95% CI: 0.68 to 0.97), cumulative live births (OR: 0.90, 95% CI: 0.78 to 1.04), or the occurrence of OHSS (OR: 0.83, 95% CI: 0.54 to 1.28). Gonadotropin dosage required for ovarian stimulation also showed no significant difference (MD: -15.32, 95% CI: -79.79 to 49.15). At the same time, we analyzed different ovulation induction regimens and found that there was no statistically significant miscarriage rate between the GnRH agonist (standard long regimen) after COC pre-treatment and the control group (OR: 1.12, 95% CI: 0.79 to 1.59), while there was no significant difference between the live birth rate with GnRH agonist (standard long regimen) after contraceptive pre-treatment and the control group (OR: 0.85, 95% CI: 0.64 to 1.14).Conclusions: Administering COC pre-treatment for patients with PCOS undergoing ART does not provide substantial advantages in terms of clinical pregnancy, cumulative pregnancy, live birth rates, or the reduction of OHSS incidence. However, it is associated with an increased risk of miscarriage.
Keywords: Polycystic Ovary Syndrome, Combined oral contraceptives, Assisted Reproductive Technology, live birth rate, Meta-analysis
Received: 15 Dec 2024; Accepted: 19 May 2025.
Copyright: © 2025 Liang, Zhang and Lou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhaoxia Lou, Huzhou Maternity and Child Health Care Hospital, Huzhou, China
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