Effect of low‐dose dexamethasone on patients with elevated early follicular phase progesterone level and pregnancy outcomes in <scp>IVF</scp>‐<scp>ET</scp> treatment: A randomized controlled clinical trial

Liu, Shan; Shi, Lin; Wang, Tao; Shi, Juanzi

doi:10.1111/cen.13824

Cited by 10 publications

(5 citation statements)

References 20 publications

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“…The glucocorticoid administration in women undergoing controlled ovarian hyper-stimulation is not established [74], with no support data of efficacy of methylprednisolone in the correlation between OHSS incidence and clinical outcomes [75]. Dexamethasone increased ovary response to gonadotropin stimulation, suppressed the progesterone secretion, and determined a higher cumulative live-birth rate [76].…”

Section: Ovarian Stimulation (Os) Protocolsmentioning

confidence: 99%

Key Points in Fertility Preservation Treatment Strategies During Covid-19 Pandemic. An Update on Pharmacological Therapies

Varlas¹

2021

FARMACIA

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The fertility preservation (FP) field has developed in the two decades and offers women the possibility to have genetic children at some point in life. Fertility preservation is urgent by definition, performed for social reasons or medical indications, such as impending gonadotoxic therapy or radical gynaecological surgery. One year after the pandemic was declared, the COVID-19 infection imposed several restrictions and limited access to health care for the infertile couple. Ovarian stimulation is a pharmacological treatment used to induce the development of ovarian follicles; FP guidelines provide different options for ovarian stimulation. We performed a systematic search on fertility preservation (FP) procedures during the COVID-19 pandemic using the keywords: FP, ovarian stimulation, assisted reproduction techniques (ART), and COVID-19. In order to update the different treatment strategies in ovarian stimulation on fertility preservation studied in the last ten years, we searched for randomized clinical trials (RCTs) focused on therapeutic agents used in current protocols, gonadotropins, gonadotropin releasing hormone (GnRH), clomiphene citrate (CC), letrozole, androgens, metformin, tamoxifen, glucocorticoids, aspirin, coenzyme Q10, and sildenafil. Fertility may be influenced by SARS-CoV-2 infection -especially in men; until more evidence confirms the effects on fertility, patients with COVID-19 positive should delay FP procedures if possible. Access to fertility conservation services decreased during the analysed period due to the medical services restrictions and the reorientation of medical resources on patients with COVID-19, without major changes in the current therapeutic protocols. In terms of pharmacotherapy in ovarian stimulation (OS) procedures, letrozole is first line therapy, superior to CC for OS. Similar ovulation and pregnancy rate can be obtained in letrozole -induced ovulation compared to gonadotropin protocol. Adjuvant therapies may be used for OS but lack proven efficacy. Further studies on adjuvant therapies and complementary support are needed, to ensure optimal condition in assisted reproductive interventions for fertility preservation, especially in gonadotoxic therapies. primă linie, superior clomifenului (CC) în OS. O ovulație și o rată de sarcină similară pot fi obținute în ovulația indusă de letrozol în comparație cu protocolul gonadotropinei. Terapiile adjuvante pot fi utilizate pentru OS, dar nu au o eficacitate dovedită. Sunt necesare studii suplimentare privind terapiile adjuvante și sprijinul complementar, pentru a asigura o stare optimă în intervențiile de reproducere asistată pentru conservarea fertilității, în special în terapiile gonadotoxice.

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Section: Ovarian Stimulation (Os) Protocolsmentioning

confidence: 99%

Key Points in Fertility Preservation Treatment Strategies During Covid-19 Pandemic. An Update on Pharmacological Therapies

Varlas¹

2021

FARMACIA

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“…Also, GCs were found beneficial in a group of patients with autoantibodies undergoing IVF, while their use in general IVF population showed ambiguous action [1,19]. In a couple of studies, GCs increased clinical pregnancy rate without changing live birth rate [7,[19][20][21], whilst in the study of Liu et al [22] there was no difference in clinical pregnancy rate but with the significantly higher cumulative live-birth rate.…”

Section: Discussionmentioning

confidence: 99%

Short-term dexamethasone plus acetylsalicylic acid treatment during in vitro fertilization procedure

et al. 2019

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Objectives: Embryo implantation represents the major limiting step during in vitro fertilization (IVF) procedure. Immunological and coagulation abnormalities were shown to have a substantial part in multifactorial etiology of IVF failure. We aimed to investigate the effect of short-term low-dose dexamethasone plus acetylsalicylic acid (ASA) treatment, starting at the time of embryo transfer, on the implantation and clinical pregnancy rates in general IVF population. Material and methods:Out of 233 consecutive patients undergoing fresh IVF/intracytoplasmic sperm injection (ICSI) cycles 64 received an adjuvant treatment consisting of dexamethasone (0.5 mg/day) plus ASA (100 mg/day) (DA group), starting on the day of embryo transfer. Patients not receiving these medications comprised a control group.Results: Significantly more patients in DA group had positive ß-hCG values than controls (59.38% vs. 37.67%, p = 0.004) (OR = 2.42, 95% CI: 1.33-4.41). Implantation rate was 26.53% in DA group and 15.92% in controls (p = 0.0294). Clinical pregnancy rate per started cycle was higher in DA group (43.59%) than controls (28.92%), but the difference was not significant (p = 0.0879; OR = 1.99, 95% CI: 0.89-4.41). Conclusions:Our study shows a potential benefit of dexamethasone plus ASA adjuvant treatment in females undergoing IVF/ICSI procedure. As these results show improvement of IVF outcome, a greater number of patients undergoing this type and regime of adjuvant treatment should be investigated.

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“…The use of glucocorticoids during maternal preparations for IVF can sensitize the ovaries to gonadotropin stimulation ( 16 , 17 ), and due to the increased level of estradiol after ovulation induction, both hormones can suppress the immune system and reduce maternal immunoresistance. In addition, changes to maternal hormone concentrations during pregnancy (especially the increase in estrogen) are capable of inhibiting the immune function of maternal lymphocytes ( 18 ), thus reducing maternal resistance and thereby precipitating tuberculosis or its recurrence in pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Congenital tuberculosis in a neonate following in vitro fertilization-embryo transfer: A case report

Zhuang

Yang

et al. 2022

Front. Pediatr.

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BackgroundCongenital tuberculosis is becoming increasingly common, but congenital tuberculosis infection in neonates following in vitro fertilization and embryo transfer (IVF-ET) has been rarely reported; a diagnosis of congenital tuberculosis is often delayed due to the non-specificity of maternal IVF treatments and clinical manifestations during pregnancy—particularly in low-birth-weight preterm infants.Case presentationWe herein report a case of congenital tuberculosis. The infant was born at 27+5 weeks of gestation and was admitted to the hospital due to hypopnea after birth. Due to a poor response to treatment, we conducted pathogenic microorganism metagenomic analysis to assess the nucleotide sequences within the Mycobacterium tuberculosis complex. After collecting sputum, the strains from the tuberculosis analysis were isolated and confirmed. From a detailed examination of the mother and in accordance with the child's congenital tuberculosis, we confirmed the diagnosis of pelvic tuberculosis.ConclusionIVF treatment and pregnancy can exacerbate latent tuberculosis, especially in women from a family with a history of tuberculosis infections. We posit that the optimal way to prevent neonatal congenital tuberculosis in IVF-ET is to procure a detailed maternal medical or family history and to identify and treat maternal tuberculosis during IVF treatment.

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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

Cited by 10 publications

References 20 publications

Key Points in Fertility Preservation Treatment Strategies During Covid-19 Pandemic. An Update on Pharmacological Therapies

Key Points in Fertility Preservation Treatment Strategies During Covid-19 Pandemic. An Update on Pharmacological Therapies

Short-term dexamethasone plus acetylsalicylic acid treatment during in vitro fertilization procedure

Congenital tuberculosis in a neonate following in vitro fertilization-embryo transfer: A case report

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