Gonadotropins and glucocorticoid therapy for "low responders"--a controlled study.
OBJECTIVE
A randomized, nonplacebo controlled study was conducted to determine the effect of dexamethasone supplementation to a protocol of gonadotropin therapy in 42 "low-responder patients" aged 32 to 43 years.


METHODS
All underwent at least two previous cycles treated by gonadotropins for unexplained infertility, or anovulation. Human menopausal gonadotropin was started on day 4 of the menstrual cycle combined with dexamethasone 0.5 mg administered nightly, as an adjuvant. A group of "low responders" who did not receive dexamethasone served as the controls. The number of follicles, total amount of gonadotropins used, time required for stimulation, fertilization, peak estradiol levels and pregnancy rate were evaluated.


RESULTS
The number of developing follicles, estradiol levels, fertilization rate and pregnancy rate did not differ significantly.


CONCLUSIONS
Although certain beneficial effects were observed in the literature in some of the infertile patients treated with corticosteroids, the overall results did not support daily, low-dose dexamethasone (long-acting corticosteroid) as a clinically useful adjuvant therapy for "low responders" during gonadotropin therapy.
Bider
D
D
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Blankstein
J
J
Levron
J
J
Tur-Kaspa
I
I
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage / Q000627:therapeutic use*; D002996:Clomiphene / Q000627:therapeutic use; D003907:Dexamethasone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood; D005260:Female; D005306:Fertilization; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy*; D008596:Menotropins / Q000008:administration & dosage / Q000627:therapeutic use*; D006080:Ovarian Follicle; D010062:Ovulation Induction / Q000379:methods*; D011247:Pregnancy; D018873:Pregnancy Rate; D016896:Treatment Outcome
D006063:Chorionic Gonadotropin; D002996:Clomiphene; D004958:Estradiol; D008596:Menotropins; D003907:Dexamethasone