Treatment with piroxicam before embryo transfer increases the pregnancy rate after in vitro fertilization and embryo transfer.
OBJECTIVE
To examine the effect of beta-cyclodextrin piroxicam treatment for priming of the uterus on the pregnancy outcome of IVF-embryo transfer (ET) programs.


METHODS
Prospective, randomized, double-blinded placebo-controlled clinical study.


METHODS
Large urban medical center.


METHODS
One hundred eighty-eight consecutive cycles of fresh IVF-ET and 78 cycles of frozen-thawed ET. The patients underwent IVF because of tubal, male infertility, unexplained, or endometriosis factors. They were randomly divided into treatment and control groups.


METHODS
In the treatment group, 94 cycles in fresh ET and 39 cycles in frozen-thawed ET the patients received an oral dose of 10 mg of piroxicam. In the control group, the same number cycles corresponding to the treatment group were treated with placebo. Both groups started piroxicam or placebo treatment 1-2 hours before ET. Patients and staff were blinded to the treatment.


METHODS
Implantation rate (IR) and pregnancy rate (PR).


RESULTS
Piroxicam increased significantly IR (18.7%) and PR (46.8%) compared to the control group (8.6% and 27.6%, respectively) in fresh cycles. With the exception of an unexplained factor, patients with the tubal, male infertility, or endometriosis factor had significantly higher PR in the treatment group compared to the control group. The beneficial effect of piroxicam was found in patients less than 40 years old, but was not found in patients more than 40 years. In frozen-thawed cycles, there were statistically significant differences between the treatment group and the control group in IR (9.4% vs. 2.3%) and PR (25.6% vs. 7.7%), respectively.


CONCLUSIONS
Our study showed that piroxicam increases IR and PR after IVF-ET in both fresh and frozen-thawed ET cycles. The beneficial effect seems to be more remarkable in patients less than 40 years old with tubal, male infertility, or endometriosis factors. These results suggest that piroxicam treatment before ET is very effective in the priming of a uterus suitable for embryo implantation. This is the first study to investigate the possible consequence of piroxicam for improving the PR after IVF-ET.
Center for Reproductive Medicine and Infertility, Department of Obstetrics and Gynecology, Good Moon-Hwa Hospital, Busan, Korea.
Hwa Sook
HS
Moon
Sea Hee
SH
Park
Ju Ok
JO
Lee
Kyung Seo
KS
Kim
Bo Sun
BS
Joo
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D004311:Double-Blind Method; D010064:Embryo Implantation / Q000187:drug effects*; D004624:Embryo Transfer; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D005640:Follicle Stimulating Hormone / Q000097:blood; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D010062:Ovulation Induction / Q000379:methods; D010894:Piroxicam / Q000627:therapeutic use*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone