Does treatment with dexamethasone improve IVF outcomes in patients with elevated progesterone?

This study investigated if dexamethasone (Ozurdex) improves the success of in vitro fertilization (IVF) in patients with elevated progesterone.

They found that low-dose dexamethasone resulted in a higher birth rates following IVF.

During fertility treatment, women may undergo ovarian stimulation to produce eggs to harvest for IVF and embryo transfer (ET) into the womb. One type of medication used to do this are gonadotrophin-releasing hormone agonists (GnRHa).

Progesterone is an important hormone in pregnancy. It helps maintain the uterine (womb) lining during pregnancy to allow the embryo to attach and grow. It is produced by cells in the ovaries and the adrenal gland. High levels of progesterone may also cause complications for the growth of the follicle.

Dexamethasone is a drug that can reduce progesterone production. It is unclear if dexamethasone treatment can improve fertility outcomes in patients with high progesterone levels.

This study included 459 women undergoing fertility treatment. Patients were randomly assigned to receive either 0.75mg/d dexamethasone (treatment group) or no intervention (control group) during ovarian stimulation. Patients were followed to determine if a successful pregnancy and live birth were achieved.

Progesterone levels were significantly lower in the treatment group than the control group on the day ovulation was triggered. Clinical pregnancy rates were similar in both groups, however, birth rates were higher in patients that received dexamethasone (70%, versus 61% for control). There were no significant side effects reported by the pregnant mother and neonatal outcomes, such as birthweight, congenital malformations, etc., were similar in both groups.

The authors concluded that low dose dexamethasone resulted in a higher birth rates following IVF-ET.

The number of patients included in this study is small. A large study, with a longer follow-up period is important to ensure there are no lasting negative effects on the infant’s development.

If you have any concern regarding ovarian stimulation then please consult with your doctor.