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Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aims to investigate the effects of pre-treatment with Combined Oral Contraceptives (COC) on the prognosis of individuals with polycystic ovary syndrome (PCOS) who undergo assisted reproductive technology (ART).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three databases (PubMed, Embase, and Cochrane Library) were searched from their establishment until February 23, 2024. Literature screening was performed based on predefined inclusion and exclusion criteria. Meta-analysis was executed using Stata 14.0 software, with outcomes expressed as mean differences (MD) and odds ratios (ORs), with 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our comprehensive analysis comprised of 11 studies, encompassing a total of 4413 patients diagnosed with PCOS. Meta-analysis results revealed that, compared to no pre-treatment, the use of COC pre-treatment did not significantly improve clinical pregnancy rates (OR: 0.96, 95% CI: 0.85 to 1.09), cumulative pregnancy rates (OR: 1.13, 95% CI: 0.92 to 1.39), or implantation rates (OR: 1.16, 95% CI: 0.99 to 1.36). However, the use of COC pre-treatment was found to be linked to a higher rate of miscarriage (OR: 1.29, 95% CI: 1.01 to 1.65). Additionally, it did not have a significant impact on the rate of live births (OR: 0.81, 95% CI: 0.68 to 0.97), cumulative live births (OR: 0.90, 95% CI: 0.78 to 1.04), or the occurrence of OHSS (OR: 0.83, 95% CI: 0.54 to 1.28). Gonadotropin dosage required for ovarian stimulation also showed no significant difference (MD: -15.32, 95% CI: -79.79 to 49.15). At the same time, we analyzed different ovulation induction regimens and found that there was no statistically significant miscarriage rate between the GnRH agonist (standard long regimen) after COC pre-treatment and the control group (OR: 1.12, 95% CI: 0.79 to 1.59), while there was no significant difference between the live birth rate with GnRH agonist (standard long regimen) after contraceptive pre-treatment and the control group (OR: 0.85, 95% CI: 0.64 to 1.14).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Administering COC pre-treatment for patients with PCOS undergoing ART does not provide substantial advantages in terms of clinical pregnancy, cumulative pregnancy, live birth rates, or the reduction of OHSS incidence. However, it is associated with an increased risk of miscarriage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/prospero<\/jats:uri>, identifier CRD42024528652.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1545508","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T04:10:33Z","timestamp":1749096633000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of pre-treatment with oral short-acting contraceptives on assisted reproductive technology outcomes in patients with polycystic ovary syndrome: a meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yufei","family":"Liang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiquan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxia","family":"Lou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rbmo.2019.03.203","article-title":"A meta-analysis of pregnancy-related outcomes and complications in women with polycystic ovary syndrome undergoing IVF","volume":"39","author":"Sha","year":"2019","journal-title":"Reprod biomedicine Online"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2022.2108702","article-title":"Current and emerging drug treatment strategies for polycystic ovary syndrome","volume":"24","author":"Helvaci","year":"2023","journal-title":"Expert Opin pharmacotherapy"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deaa371","article-title":"Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017","volume":"36","author":"Liu","year":"2021","journal-title":"Hum Reprod"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgad463","article-title":"Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome","volume":"108","author":"Teede","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B5","doi-asserted-by":"publisher","first-page":"583","DOI":"10.3390\/ijms23020583","article-title":"Polycystic ovary syndrome: A comprehensive review of pathogenesis, management, and drug repurposing","volume":"23","author":"Sadeghi","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B6","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1001\/jama.2021.4788","article-title":"Diagnosis and management of infertility: A review","volume":"326","author":"Carson","year":"2021","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"crossref","DOI":"10.1097\/MED.0000000000000780","article-title":"Optimization of assisted reproductive technology outcomes in patients with polycystic ovarian syndrome: updates and unanswered questions","volume":"29","author":"Fitz","year":"2022","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.13051","article-title":"A brief update on the evidence supporting the treatment of infertility in polycystic ovary syndrome","volume":"59","author":"Costello","year":"2019","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2020.615957","article-title":"Factors associated with ovarian hyperstimulation syndrome (OHSS) severity in women with polycystic ovary syndrome undergoing IVF\/ICSI","volume":"11","author":"Sun","year":"2021","journal-title":"Front Endocrinol (Lausanne)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S500692","article-title":"Impact of polycystic ovary syndrome hyperandrogenic phenotypes A and non-hyperandrogenic D on pregnancy outcomes after in vitro fertilization (IVF)\/intracytoplasmic sperm injection (ICSI)","volume":"17","author":"Khamaiseh","year":"2025","journal-title":"Int J Womens Health"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogoh.2019.03.025","article-title":"Effect of chlormadinone acetate versus drospirenone-containing oral contraceptives on the endocrinal features of women with polycystic ovary syndrome: Systematic review and meta-analysis of randomized clinical trials","volume":"48","author":"Menshawy","year":"2019","journal-title":"J gynecol obstetrics Hum Reprod"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-019-05210-z","article-title":". 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