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


METHODS
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


CONCLUSIONS
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.
Taniguchi
Fumiaki
F
Department of Obstetrics and Gynecology, Ehime University of Medicine, Ehime, Japan. ftaniguc@kyotolan.hosp.go.jp
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D001327:Autoimmune Diseases / Q000188:drug therapy / Q000628:therapy; D004305:Dose-Response Relationship, Drug; D010064:Embryo Implantation / Q000276:immunology; D004624:Embryo Transfer; D005260:Female; D005307:Fertilization in Vitro; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000628:therapy*; D011239:Prednisolone / Q000494:pharmacology* / Q000627:therapeutic use; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D012189:Retrospective Studies
D000974:Antibodies, Antinuclear; D005938:Glucocorticoids; D011239:Prednisolone