GONADOTROPINS AND GLUCOCORTICOID THERAPY FOR LOW RESPONDERS - A CONTROLLED-STUDY

Purpose: A randomized, nonplacebo controlled study was conducted to de termine the effect of dexamethasone supplementation to a protocol of g onadotropin therapy in 42 ''low-responder patients'' aged 32 to 43 yea rs. Methods: All underwent at least two previous cycles treated by gon adotropins for unexplained infertility, or anovulation. Human menopaus al gonadotropin was started on day 4 of the menstrual cycle combined w ith dexamethasone 0.5 mg administered nightly, as an adjuvant. A group of ''low responders'' who did not receive dexamethasone served as the controls. The number of follicles, total amount of gonadotropins used , time required for stimulation, fertilization, peak estradiol levels and pregnancy rate were evaluated Results: The number of developing fo llicles, estradiol levels, fertilization rate and pregnancy rate did n ot differ significantly. Conclusions: Although certain beneficial effe cts were observed in the literature in some of the infertile patients treated with corticosteroids, the overall results did not support dail y low-dose dexamethasone (long-acting corticosteroid) as a clinically useful adjuvant therapy for ''low responders'' during gonadotropin the rapy.