Successful glucocorticoid treatment for patients with abnormal autoimmunity on in vitro fertilization and embryo transfer.
OBJECTIVE
To analyze the effects of glucocorticoid treatment for patients with abnormal autoimmunity on IVF-ET outcomes, low-dose predonisolone or dexamethasone was administered in 51 IVF-ET cycles of 41 patients with positive antinuclear antibody (ANA), anti-DNA antibody, and/or lupus anticoagulant (LAC). Rates of clinical pregnancy and implantation in these patients were compared with those in 48 cycles without corticosteroid therapy. Autoantibody-negative patients were also treated with IVF-ET combined with (29 cycles) or without (57 cycles) glucocorticoid administration, and the pregnancy and implantation rates were investigated.


RESULTS
Without glucocorticoid treatment, the pregnancy rate per cycle and implantation rate per embryo in antibody-positive patients were 10.4 and 3.8%, respectively. Significant increases in pregnancy (35.3%) and implantation (13.2%) rates were observed with corticosteroid treatment. In antibody-negative patients, the rates of pregnancy and implantation showed no significant differences with versus without the glucocorticoid administration.


CONCLUSIONS
Our results indicate that because autoimmune abnormalities may be at least one cause of implantation failure following IVF-ET, the combined use of low-dose corticosteroid can be effective for autoantibody-positive women.
Ando
T
T
Department of Obstetrics and Gynecology, Branch Hospital, Nagoya University School of Medicine, Japan.
Suganuma
N
N
Furuhashi
M
M
Asada
Y
Y
Kondo
I
I
Tomoda
Y
Y
D000328:Adult; D000974:Antibodies, Antinuclear / Q000276:immunology; D001323:Autoantibodies / Q000032:analysis / Q000276:immunology; D001327:Autoimmune Diseases / Q000188:drug therapy*; D015551:Autoimmunity / Q000276:immunology; D003907:Dexamethasone / Q000627:therapeutic use; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D016682:Lupus Coagulation Inhibitor / Q000276:immunology; D011239:Prednisolone / Q000627:therapeutic use; D011247:Pregnancy; D018873:Pregnancy Rate
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D005938:Glucocorticoids; D016682:Lupus Coagulation Inhibitor; D003907:Dexamethasone; D011239:Prednisolone