A randomized controlled trial of NuvaRing versus combined oral contraceptive pills for pretreatment in in vitro fertilization cycles

ObjectiveTo determine whether use of the NuvaRing (Merck) for pretreatment in IVF cycles would result in better cycle control and patient satisfaction versus a 30-μg oral contraceptive (OC) pill.DesignA prospective randomized, controlled study.SettingAn academic, hospital-based fertility clinic in Toronto, Canada.Patient(s)Patients 18–37 years old, undergoing their first IVF or IVF/intracytoplasmic sperm injection (ICSI) cycle.Intervention(s)OC versus NuvaRing for IVF pre-treatment.Main Outcome Measure(s)Patient satisfaction, ovarian suppression, and IVF cycle outcomes.Result(s)Demographic data were similar in both groups. There were no significant differences in side effects between the NuvaRing and OC pill group with the exception of more breast discomfort in the OC pill group. There were no differences in the protocols, days of stimulation, and number of oocytes between the groups. Patients in the OC pill group had more embryos on day 3 and more patients had excess embryos for freezing. The number of embryos transferred and clinical pregnancy rates (PR) were similar between the two groups, although more patients in the NuvaRing group had cycles cancelled for poor stimulation.Conclusion(s)There was no significant benefit in patient tolerability or side effects with the NuvaRing versus the OC pill for IVF pretreatment; however, side effects overall were low in both groups. Clinical PRs were similar; however, the NuvaRing group had more cancelled cycles and fewer excess embryos for freezing.Clinical Trial Registration#NCT01298128.