Clinical Efficacy of Low-dose Aspirin and Prednisolone in Controlled Ovarian Hyperstimulation for In Vitro Fertilization and Embryo Transfer / 대한산부인과학회지

ABSTRACT

OBJECTIVE: To determine whether the use of low-dose aspirin and prednisolone in controlled ovarian hyperstimulation (COH) with GnRH agonist long protocol improves the outcomes of in vitro fertilization and embryo transfer (IVF-ET). METHODS: Two hundred and forty IVF-ET cycles were assigned to four groups control group (aspirin(-) and prednisolone(-), n=59), low-dose aspirin group (aspirin(+) and prednisolone(-), n=43, Group 1), prednisolone group (aspirin(-) and prednisolone(+), n=80, Group 2), and low-dose aspirin and prednisolone group (aspirin(+) and prednisolone(+), n=58, Group 3). The COH and pregnancy outcomes were retrospectively compared among the four groups. RESULTS: Group 1 showed higher fertilization rate with a borderline significance compared to control group (73.6% vs. 64.1%, p=0.050). Serum estradiol (E2) level on hCG day was 995.5+/-767.5 pg/mL in control group, 1,550.7+/-1,254.5 pg/mL in group 1, 1,469.2+/-1,206.6 pg/mL in group 2 and 1,796.0+/-1,548.0 pg/mL in group 3 and higher in the three treatment groups compared to control (p=0.012, p=0.006, p<0.001, respectively). Embryo score per transferred embryo was also higher in Group 1 (17.4+/-8.4, p=0.001) and 3 (16.0+/-6.1, p<0.001) compared to control (12.2+/-5.1). There were no significant differences in the implantation and the pregnancy rates among the four groups. CONCLUSION: The use of low-dose aspirin or prednisolone may be beneficial in IVF-ET patients undergoing COH with GnRH agonist long protocol. Further larger-scale prospective randomized investigations are necessary to confirm these findings.