To pill or not to pill in GnRH antagonist cycles: that is the question!

Worldwide, gonadotrophin-releasing hormone (GnRH) antagonists are gaining ground, and the number of patients being treated for IVF with a GnRH antagonist is increasing. Cycle planning in GnRH antagonist IVF cycles has been a challenge. During the past 2 years, debate has been ongoing about the possible disadvantages of oral contraceptive pill (OCP) pre-treatment in GnRH antagonist IVF cycles. A recent meta-analysis clearly showed a significant decrease in ongoing pregnancy rates between patients who received OCP pre-treatment and those who did not. In this review, the published meta-analysis are is evaluated. It is argued that caution must be exercised in drawing conclusions too quckly on whether or not OCP pre-treatment might have a negative effect on outcome in GnRH antagonist IVF cycles.