The clinical efficacy of the low dose aspirin and corticosteroid treatment in patients with endometriosis who underwent in-vitro fertilization and embryo transfer (IVF-ET)

Kim, Young Ah; Kim, Mi Ran; Hwang, Kyung Joo; Yoon, Jong Hyuck; Seo, Seong Seog; Ryu, Hee Sug

Abstract

OBJECTIVE
To investigate the efficacy of low-dose aspirin and corticosteroid in IVF-ET patients with endometriosis.
MATERIALS AND METHODS
45 infertile patients with endometriosis underwent 59 consecutive IVF-ET cycles. In the treatment group, 18 patients (23 cycles) underwent controlled ovarian hyperstimulation (COH) and received daily doses of 80 mg of aspirin and 15 mg of prednisone, starting on 3rd day of COH. In the control group, 27 patients (36 cycles) underwent COH without treatment. We analyzed the clinical characteristics, fertilization rates, good quality embryo ratio and pregnancy rates between these two groups.
RESULTS
There was no difference between groups in clinical characteristics (mean age, parity, LH, FSH, estradiol, progesterone), fertilization rates, and good embryo ratio. However, implantation rates were significantly different (29.81% vs. 11.06%, p=0.019). Furthermore, hCG positive rates (60.89% vs. 41.67%), clinical pregnancy rates (56.52% vs. 33.33%), and on going pregnancy rates (>20weeks) (47.83% vs. 27.78%) were increased in the study group compared to the control group.
CONCLUSIONS
Combined treatment of low dose aspirin and prednisone improved pregnancy rates and implantation rates in IVF-ET patients with endometriosis. This results confirm the hypothesis that autoantibodies subsequently react with endometrial antigen leading to implantation failure and that we need to further research to the relationship of endometriosis with the immunologic aspect of implantation.