Dexamethasone as a supplement for exogenous gonadotropin to improve ovarian response of women over 35 years undergoing IVF/ICSI cycles

ABSTRACT

With aging, the ovarian reserve is decreased and that is a major contributor to poor ovarian response to exogenous gonadotropins. The aim of the present study is to evaluate the role of Dexamethasone on ovarian response in infertile patients aged over 35 years undergoing IVF/ICSI cycles. In this triple blind placbo-control clinical trial study, a total of 72 infertile women over age 35, undergoing IVF/ICSI cycles, referred to Royan Institute from May 2000 to May 2002 were selected. Dexamethasone co-treatment [1mgld] was started on the 21st of their preceding menstrual cycle and it was continued until oocyte aspiration. The main outcome measures were number of retrieved oocytes, number of fertilized and transferred embryos, number of used HMG, serum E2 level on HCG injection day, and pregnancy rate. There was no significant statistical difference in age, duration of infertility, Body mass index, hormonal tests, number of retrieved oocytes and transferred embryos. However, the number of used HMG was significantly lower in Dexamethasone group compared to placebo group [30.6 +/- 13.39 versus 41.64 +/- 18.34] [p<0.05]. The addition of dexamethasone 1mgld to standard long protocol decreased the number of itme used in patients over 35 years who hold known risk of low ovarian response