Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation: a retrospective cohort study

Research question To evaluate the possible association of various forms of hormonal and non-hormonal contraceptives on controlled ovarian stimulation outcomes such as oocyte yield and maturation in patients undergoing planned oocyte cryopreservation (POC). Design A Retrospective Cohort Study included all patients that underwent POC cycles between 2011 and 2023. Utilization of types of contraception before a planned oocyte cryopreservation cycle was recorded. We evaluated the median number of cumulus cell-oocyte complexes obtained after a vaginal oocyte retrieval and proportion of metaphase II oocytes that underwent vitrification among all cohorts. Results 4,059 oocyte freezing cycles were included in the analysis, eight types of contraceptive methods were recognized in patients undergoing ovarian stimulation including: IUD copper (n=84), IUD Levonorgestrel low dose (<52mg) (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=2,349), Norelgestromin Transdermal Patch (n=10). A control group of patients not using contraceptives or utilizing barrier or calendar methods (n=1,220). The median number of cumulus cell-oocyte complexes captured during the oocyte retrieval were comparable among all cohorts (p= 0.054), a significant difference in oocyte maturity rate with median number of cryopreserved oocytes was found among cohorts (p= 0.04 and p= <0.001 respectively). In a multivariate analysis after adjusting for confounders no association was found between types of contraceptives and proportions of MII oocytes available for cryopreservation. Conclusions Among the various forms of contraception, none were shown to have an adverse association with the oocyte yield or maturation rate in patients undergoing planned oocyte cryopreservation.