Dexamethasone supplementation to gonadotropin stimulation for in vitro fertilization in polycystic ovarian disease.
OBJECTIVE
This study was conducted to determine whether glucocorticoid supplementation for patients with polycystic ovarian disease during ovulation induction with gonadotropins for in vitro fertilization (IVF) therapy is beneficial.


METHODS
Seventy-one cycles of patients undergoing first attempts at IVF, with classical polycystic ovarian disease and hyperandrogenemia, who enrolled in the IVF-embryo transfer program, were evaluated retrospectively. In 20 cycles (20 patients) glucocorticoid supplementation was noted and compared to 51 cycles (51 patients) without glucocorticoid as adrenal androgen suppression. Ovaries were stimulated by gonadotropin releasing hormone agonist, human menopausal gonadotropin, and dexamethasone. Ovarian responsiveness and IVF-embryo transfer outcome were analyzed and included the number of follicles > 17 mm in diameter, serum estradiol concentration on the day of human chorionic gonadotropin administration, number of human chorionic gonadotropin ampoules administered, number of oocytes retrieved, percentage of oocytes fertilized, number of embryos transferred, implantation rate, and number of clinical pregnancies and their outcome.


RESULTS
The results showed that the pregnancy rate in patients who received glucocorticoid was 22.1%, compared to 26% in the controls (statistically insignificant). The IVF cycle variables studied revealed no statistically significant differences.


CONCLUSIONS
Our observations did not support the notion that adrenal androgen suppression by glucocorticoid, or as an adjuvant therapy, is beneficial to patients with polycystic ovarian disease who enrolled in an IVF-embryo transfer program.
Bider
D
D
Department of Obstetrics and Gynecology, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Hourvitz
A
A
Tur Kaspa
I
I
Dirnfeld
M
M
Dor
J
J
D000328:Adult; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005640:Follicle Stimulating Hormone / Q000097:blood; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D017588:Hyperandrogenism / Q000188:drug therapy; D010062:Ovulation Induction; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies
D006063:Chorionic Gonadotropin; D005938:Glucocorticoids; D003907:Dexamethasone; D005640:Follicle Stimulating Hormone