Results of prednisolone given to improve the outcome of in vitro fertilization-embryo transfer in women with antinuclear antibodies

J Reprod Med. 2005 Jun;50(6):383-8.

Abstract

Objective: To evaluate the association of antinuclear antibodies (ANA) with outcome of in vitro fertilization-embryo transfer (IVF-ET) as well as the effect of short-term immunosuppression with prednisolone on implantation, clinical pregnancy and live birth rates following IVF-ET.

Study design: The study group consisted of 120 women, 22-42 years old, in whom IVF-ET was performed and whose ANA could be measured. Prednisolone (15-60 mg/d for 5 days) was administered starting 1 day after oocyte retrieval to some women with or without ANA, without randomization. The 223 IVF-ET cycles were divided into prednisolone-nontreated ANA-negative cycles, prednisolone-treated ANA-negative cycles, prednisolone-nontreated ANA-positive cycles and prednisolone-treated ANA-positive cycles. Retrospective analysis of rates of implantation, clinical pregnancy, and live birth were evaluated in the four groups.

Results: Overall, ANA positivity was noted in 20.0% of subjects (24/120) and 25.1% of cycles (56/223). Implantation and clinical pregnancy rates in the prednisolone-nontreated ANA-positive group were 0% (0/41 transplanted embryos) and 0% (0/15 cycles), significantly lower than in the other groups. The live birth rate in this group was significantly lower than in the prednisolone-nontreated ANA-negative group and non-significantly tended to be lower than in the other 2

Conclusion: Implantation, clinical pregnancy and live birth rates following IVF-ET were low when ANA was detected. Implantation and clinical pregnancy rates were improved significantly by prednisolone, but the live birth rate was not.

MeSH terms

  • Adult
  • Antibodies, Antinuclear / blood*
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / therapy
  • Dose-Response Relationship, Drug
  • Embryo Implantation / immunology
  • Embryo Transfer*
  • Female
  • Fertilization in Vitro*
  • Glucocorticoids / pharmacology*
  • Glucocorticoids / therapeutic use
  • Humans
  • Infertility, Female / drug therapy
  • Infertility, Female / therapy*
  • Prednisolone / pharmacology*
  • Prednisolone / therapeutic use
  • Pregnancy
  • Pregnancy Outcome
  • Pregnancy Rate
  • Retrospective Studies

Substances

  • Antibodies, Antinuclear
  • Glucocorticoids
  • Prednisolone