使用類固醇對胚胎著床率無明顯提升作用

Fertil Steril. 2017 May 10. pii: S0015-0282(17)30307-2. doi: 10.1016/j.fertnstert.2017.04.003. [Epub ahead of print]

Old habits die hard: retrospective analysis of outcomes with use of corticosteroids and antibiotics before embryo transfer.

Kaye L1, Bartels C1, Bartolucci A1, Engmann L1, Nulsen J1, Benadiva C2.

Author information

Abstract

OBJECTIVE:

To evaluate clinical pregnancy rates in embryo transfer (ET) cycles with and without peri-implantation corticosteroid and oral antibiotic administration.

DESIGN:

Retrospective cohort study.

SETTING:

University-affiliated in vitro fertilization (IVF) clinic.

PATIENT(S):

Eight hundred and seventy-six ETs with or without the routine use of methylprednisolone and doxycycline.

INTERVENTION(S):

Embryo transfer procedures.

MAIN OUTCOME MEASURE(S):

Clinical pregnancy rates (CPR).

RESULT(S):

The CPR with the routine use of methylprednisolone and doxycycline was 56.1% compared with 61.5% after discontinuation of these medications. Ongoing pregnancy rates were 49.5% with medications versus 53.2% without medications. Of the cleavage-stage embryos, 79% underwent assisted hatching; among these, the CPR was 28.7% when treated with corticosteroids and antibiotics compared with 47.4% without medications.

CONCLUSION(S):

No statistically significant difference in overall IVF outcomes was noted after the discontinuation of routine peri-implantation corticosteroids and antibiotics. The use of these medications varies across the country and may be a result of habit rather than evidence-based medicine.