Effect of prednisolone on serum and follicular fluid androgen concentrations in women with polycystic ovary syndrome undergoing in-vitro fertilization

Increased androgen concentrations are thought to be detrimental to oocyte q uality and reproductive potential. Adjuvant treatment with glucocorticoids has been tried to suppress androgens in women undergoing infertility treatm ent. In the present study 20 infertile women with polycystic ovary syndrome were prospectively randomized in a placebo-controlled study to receive eit her placebo or prednisolone 10 mg at night, during standard in-vitro fertil ization (IVF) treatment. Serum samples for assays of gonadotrophins, steroi ds and sex hormone-binding globulin (SHBG) were collected before treatment, at down-regulation, and at oocyte retrieval, Up to five follicles in each ovary were analysed separately regarding follicular fluid and oocytes, the rest according to the clinic's routines. In the placebo group, serum dehydr oepiandrosterone (DHEA) and dehydroepiandrosterone-sulphate (DHEA-S) did no t change between down-regulation and oocyte retrieval, whereas adjuvant pre dnisolone resulted in a significant decrease, In follicular fluid, adjuvant prednisolone resulted in significantly lower concentrations of DHEA-S as c ompared to placebo, no other significant differences were found. No signifi cant differences were found in embryo characteristics or pregnancy rates be tween the groups.