Should we still advise infertile couples to use (barrier) contraception before IVF down-regulation?

To determine the outcome of spontaneous conceptions in women who received GnRH agonists during mid-luteal phase down-regulation before IVF treatment.Retrospective analysis of case records and study of the literature.Two university-affiliated reproductive medicine units.Seventy-three women who conceived spontaneously after starting down-regulation with a GnRH agonist before controlled ovarian hyperstimulation.None.Course and clinical outcome of pregnancies.Seventy-four pregnancies occurred in 73 women who received a GnRH agonist. Of these patients, 6 (8%) had a biochemical pregnancy, 6 (8%) had an ectopic pregnancy, 21 (28%) miscarried, and 41 pregnancies resulted in successfully delivered babies; there were 2 cases of congenital abnormalities.These cases, together with other published data, suggest that pregnancy outcome is not adversely affected by exposure to GnRH agonist during luteal-phase down-regulation. A central register of pregnant women who received a GnRH agonist is needed.The aim was to determine the outcome of spontaneous conceptions in women who received gonadotropin-releasing hormone agonists (GnRH-a) during mid-luteal phase down-regulation before in vitro fertilization treatment. The authors reviewed available literature and retrospectively studied 73 patients from two infertility centers in Melbourne, Australia, who became pregnant after they began to take GnRH-a before controlled ovarian hyperstimulation. The main outcome measures were the course and clinical outcome of pregnancies. 74 pregnancies occurred in 73 women who received GnRH-a. Of these patients, 6 (8%) had a biochemical pregnancy, 6 (8%) had an ectopic pregnancy, 21 (28%) had a miscarriage, and 41 pregnancies resulted in successfully delivered babies, with 2 cases of congenital abnormalities. These cases, together with other published data, indicate that pregnancy outcome is not adversely affected by exposure to GnRH-a during luteal phase down-regulation. A central register of pregnant women who received GnRH-a is needed.