Effectiveness of Low Dose Aspirin and Prednisolone Supplementation for IVF-ET

Hur, Kuol; Park, Chan Woo; Kim, Hye Ok; Kim, Jin Yeong; Yang, Kwang Moon; Koong, Mi Kyoung; Kang, In Soo

Abstract

OBJECTIVE
To estimate the efficacy of low-dose aspirin and prednisolone supplementation in women undergoing controlled ovarian hyperstimulation (COH) for in vitro fertilization and embryo transfer (IVF-ET).
METHODS
From 1 July 2001 to 31 July 2002, A total of 306 cycles from 306 patients who attended infertility clinic at Samsung Cheil Hospital was enrolled in this study. With pituitary desensitization in a short gonadotrophin-releasing hormone (GnRH) agonist protocol, recombinant FSH (Puregon, Organon, Netherlands) was administered for ovarian stimulation, until the largest follicle had a mean diameter > 18 mm and at least two other follicles with a diameter of 16 mm. In study group (128 cycles), low dose aspirin (100 mg/day) and prednisolone (5 mg/day) were administered from COH starting day to post-oocyte retrieval 12th day. The COH protocol of control group (178 cycles) was same as study group, except no additional supplementation. Retrospectively, we analysed ovarian response and outcome of IVF cycles.
RESULTS
The demographic characteristics of two groups were not different. E2 on hCG day (2408.3+/-1375.4 pg/ml vs 2232.3+/-1305.1 pg/ml: p=0.261), number of retrieved oocytes (13.1+/-9.1 vs 12.5+/-8.8: p=0.680), number of good embryos transferred (3.0+/-2.5 vs 2.9+/-2.0) were not different significantly between two groups. hCG positive rate (52.3% vs 43.3%: p=0.116), biochemical pregnancy rate (23.9% vs 15.6%: p=0.224), clinical pregnancy rate (39.8% vs 36.5%: p=0.629), and clinical abortion rate (10.4% vs 6.5%: p=0.392) were not different significantly either. hCG positive rate (56.1% vs 44.7%: p=0.079) shows a increasing tendency in study group, younger than 35 years old. In study group, older than 36 years old or basal FSH > 10 mIU/ml, there were no significant improvement of ovarian response and prgnancy rate.
CONCLUSION
Low dose aspirin and prednisolone supplementation in routine IVF patients shows no significant improvement in ovarian response, pregnancy rate, and implantation rate. Also, in poor ovarian responder, this supplementation shows no benefits.