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Effect of low‐dose dexamethasone on patients with elevated early follicular phase progesterone level and pregnancy outcomes in IVF ‐ ET treatment: A randomized controlled clinical trial
Author(s) -
Liu Shan,
Shi Lin,
Wang Tao,
Shi Juanzi
Publication year - 2018
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.13824
Subject(s) - dexamethasone , follicular phase , medicine , endocrinology , pregnancy rate , pregnancy , live birth , in vitro fertilisation , human chorionic gonadotropin , randomized controlled trial , ovary , gonadotropin , biology , hormone , genetics
Summary Objective To evaluate the effect of low‐dose dexamethasone on patients with elevated early follicular progesterone levels in IVF ‐ ET treatment. Design Randomized controlled trial. Setting In vitro fertilization ( IVF ) centre. Patient(s) A total of 459 patients undergoing a first IVF / ICSI cycle. Intervention(s) If progesterone concentration exceeded 1.9 nmol/L on days 3‐4 of ovarian stimulation, the patients in dexamethasone ( DEX ) group were treated with oral dexamethasone 0.75 mg/d, and the patients in control group received no extra treatment. Main outcome measure The cumulative live‐birth rate (per cycle started) in 2 years. Results The total dose of gonadotropins (1987 ± 536 IU in DEX group vs 2135 ± 701 IU in control group, P = 0.009) and the serum concentrations of progesterone on human chorionic gonadotropin ( HCG ) day (3.1 ± 1.4 nmol/L in DEX group vs 4.0 ± 1.3 nmol/L in control group, P < 0.001) were both significantly lower in DEX group than that in control. No significant differences between the two groups were observed in the number of oocytes, two pronuclear (2 PN ) embryos and clinical pregnancy rate. In addition, the cumulative live‐birth rate was significantly higher in the DEX group than that in controls (70.0% vs 61.1%, P = 0.029, 95% confidence interval: 1.01‐2.19). Conclusion(s) Progesterone secretion can be suppressed by dexamethasone, and dexamethasone may sensitize the ovary to gonadotropin stimulation in IVF treatment. In addition, the cumulative live‐birth rate was significantly higher in the DEX group than in controls, and the obstetric and neonatal outcomes support the safety of DEX treatment in IVF .