DEXAMETHASONE DURING OVULATION INDUCTION FOR IN-VITRO FERTILIZATION -A PILOT-STUDY

The purpose of the present study was to determine whether adrenal andr ogen suppression with dexamethasone (DEX) during ovulation induction i mproves the outcome of in-vitro fertilization (IVF) cycles. A total of 25 patients with serum dehydroepiandrosterone sulphate (DHEAS) concen trations >2.5 mu g/ml were randomized to receive either 0.5 mg DEX dai ly or placebo during ovulation induction with leuprolide acetate down- regulation plus human menopausal gonadotrophins (HMG). Nine patients u ndergoing a subsequent IVF cycle were crossed over to the other treatm ent group, Ovarian responsiveness and IVF outcome variables analysed i ncluded number of follicles >12 mm in diameter, serum oestradiol conce ntrations on the day of human chorionic gonadotrophin (HCG) administra tion, number of ampoules of HMG administered, number of oocytes retrie ved, percentage of oocytes fertilized, number of embryos transferred, implantation rate and numbers of clinical pregnancies and live birth p regnancies, The 31 randomized IVF cycles revealed a trend towards a hi gher implantation rate for the placebo-treated group compared to the D EX-treated group (24 versus 10%; P = 0.07). The remainder of the IVF c ycle variables revealed no statistically significant differences, In c onclusion, the suppression of adrenal androgens with DEX in women with DHEAS concentrations >2.5 mu g/ml appears to have no beneficial effec ts on ovarian responsiveness or clinical or live birth pregnancy rates .