Low-dose acetylsalicylic acid plus prednisolone as an adjuvant treatment in IVF: a prospective, randomized study.
OBJECTIVE
To test whether adjuvant therapy with acetylsalicylic acid (ASA) and prednisolone (ASA+Pred) could improve the outcome of IVF in good-pregnancy prognosis patients.


METHODS
Prospective, randomized study.


METHODS
University hospital.


METHODS
Three hundred ninety-five infertile couples undergoing IVF.


METHODS
Patients were randomized to receive ASA+Pred (n = 97) or nothing (n = 298), in addition to the routinely used IVF medications.


METHODS
The primary endpoint was implantation rate (IR). Secondary endpoints were number of retrieved oocytes and pregnancy rate (PR). The blood flow in uterine arteries and subendometrial vessels also was measured.


RESULTS
Patients who received ASA+Pred had significantly more retrieved oocytes. The PR and IR in the study group and in controls were 50.5% and 40.6% and 25.1% and 19.4%, respectively, values that were not significantly different from one another. Uterine blood flows were not significantly different between treated and nontreated patients. A statistically significantly lower incidence of severe ovarian hyperstimulation syndrome was noted among treated patients who were at high risk of developing ovarian hyperstimulation syndrome (1.7% vs. 6.5%).


CONCLUSIONS
Adjuvant treatment with ASA+Pred improves ovarian responsiveness but does not significantly improve uterine blood fluxes, PR, and IR. It may be effective in preventing the onset of severe ovarian hyperstimulation syndrome.
Department of Obstetrical and Gynecological Sciences, Reproductive Medicine and IVF Unit, S Anna Hospital, University of Turin, Turin, Italy. fertisave@yahoo.com
Alberto
A
Revelli
Elisabetta
E
Dolfin
Gianluca
G
Gennarelli
Teresa
T
Lantieri
Marco
M
Massobrio
Jan Gunnar
JG
Holte
Ilan
I
Tur-Kaspa
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001158:Arteries / Q000000981:diagnostic imaging / Q000187:drug effects; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D010064:Embryo Implantation / Q000187:drug effects; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage* / Q000009:adverse effects; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007246:Infertility / Q000503:physiopathology / Q000628:therapy*; D054315:Oocyte Retrieval; D016471:Ovarian Hyperstimulation Syndrome / Q000209:etiology / Q000517:prevention & control; D010349:Patient Compliance; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000187:drug effects; D016896:Treatment Outcome; D014463:Ultrasonography; D014599:Uterus / Q000098:blood supply*
D000893:Anti-Inflammatory Agents; D005300:Fertility Agents, Female; D011239:Prednisolone; D001241:Aspirin