A meta-study appearing in The Cochrane Library has found that glucocorticoids, commonly prescribed to boost the chances of successful embryo implantation during IVF, are not effective.
It was previously believed that glucocorticoids made the lining of the uterus more receptive to embryo implantation, but review author Carolien Boomsma says that the practice should stop. "Empirical use of glucocorticoids is not supported by evidence from studies," she said. "Moreover, we don't know enough about the possible adverse effects of glucocorticoids in early pregnancy. Therefore, at present, glucocorticoids should not be prescribed in this way."
The review was based on success rate comparisons between would-be mothers undergoing IVF or ICSI who took glucocorticoids around the time of embryo implantation and those who did not. The researchers found no overall improvement in pregnancy rates when the assisted reproductive technologies were combined with glucocorticoid treatment.
Because IVF and ICSI techniques have only a 20 to 30 percent chance of success, practitioners routinely use glucocorticoids to boost the chances of pregnancy. But glucocorticoids can bring on problems such as infections or premature births. Though the available studies reported no significant increases in these negative outcomes, they were; "poorly and inconsistently reported. Further research is needed to clarify both benefits and harms," Boomsma said.
The study noted that future research may reveal that glucocorticoids do help specific subsets of patients. For example, women with unexplained infertility, endometriosis, recurrent implantation failure or certain immunological issues may benefit from the hormonal effects on uterine receptivity. The review did not focus specifically on these patient groups.
Center for the Advancement of Health