Abstract
Objective: The objective of our study was to explore the effect of dexamethasone (DEX), a highly potent, long-acting glucocorticoid, on the treatment outcome of 74 anovulatory women aged 21 to 29 years, with normal gonadotropins, androgen, and prolactin (PRL) serum levels who failed to conceive on antiestrogen therapy.
Methods: The patients received human menopausal gonadotropin/human chorionic gonadotropin (hMG/hCG) for ovulation induction. Starting on day 4 of the induced menstruation, hMG was administered in combination with DEX, 0.5 mg at night, or without DEX as an adjuvant treatment. The total amount of gonadotropins used, time required for stimulation, percentage of fertilization, serum estradiol levels, pregnancy rate, cumulative pregnancy rate, and abortions were recorded.
Results: There were no differences in either the cumulative pregnancy rate (54.1% in the DEX group and 52.7% in the untreated group) or the abortion rates (21.7% in the DEX group compared to 20.8% in the untreated group). The other parameters investigated also did not differ significantly between the groups.
Conclusions: The overall results did not support DEX as a clinically useful adjuvant therapy for anovulatory, normoandrogenic patients.
Similar content being viewed by others
References
Evron S, Navot D, Laufer N, Diamant YZ: Induction of ovulation with combined human gonadotropins and dexamethasone in women with polycystic ovarian disease. Fertil Steril 1983;40:183–186
Daly DC, Walters CA, Soto-Albors CE, Tohen N, Riddick DH: A randomized study of dexamethasone in ovulation induction with clomiphene citrate. Fertil Steril 1984;41:844–848
Cordray JP, Merceron RE, Siboulet B, Guillerd X, Nys P, Reboul P. Fertility disorders in 49 hyperandrogenic women desiring pregnancy. Treatment results aimed at obtaining a pregnancy in 40 hyperandrogenic infertile women and in 9 hyperandrogenic women desiring pregnancy. Rev Fr Gynecol Obstet 1994;89:267–274
Singh KB, Dunnihoo DR, Mahajan DK, Bairnsfather LE: Clomiphene-dexamethasone treatment of clomiphene-resistant women with and without the polycystic ovary syndrome. J Reprod Med 1992;37:215–218
White MC, Turner EI: Polycystic ovary syndrome. 2. Diagnosis and management. Br J Hosp Med 1994;51:349–352
Barlow DH: Patient work-up and selection for treatment.In Research and Clinical Forums. Current Understanding of Polycystic Ovarian Disease, ID Cooke, B. Lunenfeld B (eds). Kent, Royal Wells Medical Press, 1989, Vol 11(4), pp 63–70
Sarris S, Swyer GIM, Ward RHT, Lawrence DM, McGarrigle HH, Little V: The treatment of mild adrenal hyperplasia and associated infertility with prednisone. Br J Obstet Gynaecol 1978;85:251–253
Levran D, Dor J, Rudak E, Nebel L, Ben-Shlomo I, Mashiach S: Pregnancy potential of human oocytes—the effect of cryopreservation. N Engl J Med 1990;323:1153–1156
Traub AI, McFaul PB: Injectable gonadotrophins in the treatment of PCOS.In Research and Clinical Forums. Current Understanding of Polycystic Ovarian Disease, ID Cooke, B. Lunenfeld B (eds). Kent, Royal Wells Medical Press, 1989, Vol 11(4), pp 71–75
Fleming R, Coutts JRT: The use of exogenous gonadotrophins and GnRH-analogues for ovulation induction in PCO syndrome.In Research and Clinical Forums. Current Understanding of Polycystic Ovarian Disease, ID Cooke, B. Lunenfeld B (eds). Kent: Royal Wells Medical Press, 1989, Vol 11(4), pp 77–87
Zarate A, Hernandez-Ayup S, Rios-Montiel A: Treatment of anovulation in the Stein-Leventhal syndrome. Analysis of 90 cases. Fertil Steril 1971;22:188–193
Cordray JP, Siboulet B, Merceron RE, Guillerd X, Nys P: Treatment of female infertility due to hyperandrogenism. Rev Fr Gynecol Obstet 1994;89:255–266
Loy R, Seibel MM: Evaluation and therapy of polycystic ovarian syndrome. Endocrinol Metab Clin North Am 1988;17:785–813
Hull MGR: Polycystic ovarian disease: clinical aspects and prevalence.In Research and Clinical Forums. Current Understanding of Polycystic Ovarian Disease, ID Cooke, B. Lunenfeld B (eds). Kent, Royal Wells Medical Press, 1989, Vol 11(4), pp 21–33
Franks S, Reed MJ: Endocrinopathy of polycystic ovary syndrome.In Research and Clinical Forums. Current Understanding of Polycystic Ovarian Disease, ID Cooke, B Lunenfeld (eds). Kent, Royal Wells Medical Press, 1989, Vol 11(4), pp 35–45
Carmina E, Gonzalez F, Chang L, Lobo RA: Reassessment of adrenal androgen secretion in women with polycystic ovary syndrome. Obstet Gynecol 1995;85:971–982
Cedars MI, Steingold KA, de Ziegler D, Lapolt PS, Chang RJ, Judd HL: Long-term administration of gonadotropin-releasing hormone agonist and dexamethasone: Assessment of the adrenal role in ovarian dysfunction. Fertil Steril 1992;57:495–500
Polak de Fried E, Blanco L, Lancuba S, Ash RH: Improvement of clinical pregnancy rate and implantation rate of in-vitro fertilization-embryo transfer patients by using methylprednisone. Hum Reprod 1993;8:393–395
Cohen J, Malter H, Elsner C, Kort H, Massey J, Mayer MP: Immunosuppression supports implantation of zona pellucida dissected human embryos. Fertil Steril 1990;53:662–665
Kemeter P, Feichtinger W: Prednisolone improves the pregnancy rate of IVF. A prospective randomized study. Fertilität 1986;2:71–76
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bider, D., Menashe, Y., Goldenberg, M. et al. Dexamethasone as an adjuvant therapy for anovulatory, normoandrogenic patients during ovulation induction with exogenous gonadotropins. J Assist Reprod Genet 13, 613–616 (1996). https://doi.org/10.1007/BF02069638
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02069638