Low-dose acetylsalicylic acid plus prednisolone as an adjuvant treatment in IVF: a prospective, randomized study

Objective

To test whether adjuvant therapy with acetylsalicylic acid (ASA) and prednisolone (ASA+Pred) could improve the outcome of IVF in good–pregnancy prognosis patients.

Design

Prospective, randomized study.

Setting

University hospital.

Patient(s)

Three hundred ninety-five infertile couples undergoing IVF.

Intervention(s)

Patients were randomized to receive ASA+Pred (n = 97) or nothing (n = 298), in addition to the routinely used IVF medications.

Main Outcome Measure(s)

The primary endpoint was implantation rate (IR). Secondary endpoints were number of retrieved oocytes and pregnancy rate (PR). The blood flow in uterine arteries and subendometrial vessels also was measured.

Result(s)

Patients who received ASA+Pred had significantly more retrieved oocytes. The PR and IR in the study group and in controls were 50.5% and 40.6% and 25.1% and 19.4%, respectively, values that were not significantly different from one another. Uterine blood flows were not significantly different between treated and nontreated patients. A statistically significantly lower incidence of severe ovarian hyperstimulation syndrome was noted among treated patients who were at high risk of developing ovarian hyperstimulation syndrome (1.7% vs. 6.5%).

Conclusion(s)

Adjuvant treatment with ASA+Pred improves ovarian responsiveness but does not significantly improve uterine blood fluxes, PR, and IR. It may be effective in preventing the onset of severe ovarian hyperstimulation syndrome.

Key Words: Acetylsalicylic acid, prednisolone, in vitro fertilization, ovarian hyperstimulation syndrome, uterine blood fluxes, embryo implantation