Impact of the levonorgestrel-releasing intrauterine device on controlled ovarian stimulation outcomes

Objective: To report differences in ovarian stimulation outcomes in women using a levonorgestrel-releasing intrauterine device (LNG-IUD). Design: Retrospective cohort study. Setting: University-based infertility practice. Patient(s): Female patients pursuing either social oocyte cryopreservation or oocyte donation. Intervention(s): Chart review of all female patients presenting from January 1, 2012, to June 30, 2017, for social oocyte cryopreservation or oocyte donation. Demographic data, cycle performance data, and the presence or absence of an LNG-IUD at the time of ovarian stimulation were compared. Main Outcome Measure(s): Total oocyte yield and total mature oocyte yield. Secondary measures included clinical pregnancy rate and live birth rate in recipients of donor oocytes. Result(s): Univariate analysis of predicted oocyte yield and mature oocyte yield showed no significant difference between subjects with and without an LNG. When controlling for history of recent hormonal contraceptive use, initial antral follicle count (AFC), age, body mass index (BMI), gonadotropin dose, and stimulation day/protocol, no significant differences were seen in total oocyte yield or mature oocyte yield in the presence or absence of an LNG-IUD. Univariate analysis of the effect of LNG-IUDs on the predicted clinical pregnancy rate and live birth rate did not significantly differ for oocyte recipients. Controlling for history of recent hormonal contraceptive use, initial AFC, age, BMI, gonadotropin dose, and stimulation day/protocol also showed no significant differences in the predicted clinical pregnancy rate and live birth rate. Conclusion(s): LNG-IUDs do not affect cycle performance in women undergoing ovarian stimulation cycles. (C) 2018 by American Society for Reproductive Medicine.