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Does combined prednisolone and low molecular weight heparin have a role in unexplained implantation failure?

  • Gynecologic Endocrinology and Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To study the effect of combined oral prednisolone and LMW heparin in ICSI in women with previously unexplained, failed implantation.

Methods

A prospective quasi-randomized, controlled trial was conducted at a university teaching hospital and a private practice setting. A total of 334 cycles (women with previously unexplained, failed one or two ICSI attempts) were assigned randomly to receive standard treatment or combined prednisolone (20 mg/day), starting on the first day of ovarian stimulation and LMW heparin 1 mg/kg/day starting 1 day after oocyte retrieval in addition to standard treatment.

Results

The mean age, number of previously failed IVF attempts, and basal FSH levels were comparable between both groups. The pregnancy and the implantation rates were significantly different between the study and control groups.

Conclusions

A combination of oral prednisolone and low molecular weight heparin may have a significant effect on pregnancy and implantation rates in prior unexplained, failed implantation.

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References

  1. Andersen AN, Goossens V, Gianaroli L, Felberbaum R, de Mouzon J, Nygren KG (2007) Assisted reproductive technology in Europe, 2003 Results generated from European registers by ESHRE. Hum Reprod 22:1513–1525

    Article  PubMed  Google Scholar 

  2. Urman B, Ata B, Yakin K, Alatas C, Aksoy S, Mercan R et al (2009) Luteal phase empirical low molecular weight heparin administration in patients with failed ICSI embryo transfer cycles: a randomized open-labeled pilot trial. Hum Reprod 24(7):1640–1647

    Article  CAS  PubMed  Google Scholar 

  3. Beer AE, Kwak JYH, Ruiz GE (1996) Immunophenotypic profiles of peripheral blood lymphocytes in women with recurrent pregnancy losses and in infertile in women with multiple failed ivf cycles. Am J Reprod Immunol 35:376–382

    Article  CAS  PubMed  Google Scholar 

  4. Lachapelle MH, Miron P, Hemmigs R, Roy DC (1996) Endometrial T, B and NK cells in patients with recurrent spontaneous abortion. J Immunol 156:4027–4034

    CAS  PubMed  Google Scholar 

  5. Ola B, Li T-C (2006) Implantation failure following in-vitro fertilization. Curr Opin Obstet Gynecol 18(4):440–445

    Article  PubMed  Google Scholar 

  6. Cline AM, Kutteh WH (2009) Is there a role of autoimmunity in implantation failure after in-vitro fertilization? Curr Opin Obstet Gynecol 21(3):291–295

    Article  PubMed  Google Scholar 

  7. Pountain GD, Keogan MT, Hazleman BL, Brown DL (1993) Effect of single dose compared with three days prednisolone treatment of healthy volunteers: contrast effects on circulating lymphocytes subset. J Clin Pathol 46:1089–1092

    Article  CAS  PubMed  Google Scholar 

  8. Fiedler K, Würfel W (2004) Effectivity of heparin in assisted reproduction. Eur J Med Res 4:207–214

    Google Scholar 

  9. Nelson SM, Greer IA (2008) The potential role of heparin in assisted conception. Hum Reprod Update 14(16):623–645

    Article  CAS  PubMed  Google Scholar 

  10. Hardarson T, Hanson C, Sjögren A, Lundin K (2001) Human embryos with unevenly sized blastomeres have lower pregnancy and implantation rates: indications for aneuploidy and multinucleation. Hum Reprod 16(2):313–318

    Article  CAS  PubMed  Google Scholar 

  11. Hasegawa I, Yamamoto Y, Suzuki M, Murakawa H, Kurabayashi T, Takakuwa K, Tanaka K (1998) Prednisolone plus low-dose aspirin improves the implantation rate in women with autoimmune conditions who are undergoing in vitro fertilization. Fertil Steril 70(6):1044–1048

    Article  CAS  PubMed  Google Scholar 

  12. Lash GE, Bulmer JN (2011) Do uterine natural killer (uNK) cells contribute to female reproductive disorders? J Reprod Immunol 88(2):156–164

    Article  CAS  PubMed  Google Scholar 

  13. Ubaldi F, Rienzi L, Ferrero S, Anniballo R, Iacobelli M, Cobellis L et al (2002) Low dose Prednisolone administration in routine ICSI patients does not improve pregnancy and implantation rates. Hum Reprod 17(6):1544–1547

    Article  CAS  PubMed  Google Scholar 

  14. Thum MY, Bhaskaran S, Abdalla HI, Ford B, Sumar N, Bansal A (2008) Prednisolone suppresses NK cell cytotoxicity in vitro in women with a history of infertility and elevated Nk cell cytotoxicity. Am J Reprod Immunol 59(3):259–265

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank Professor Hesham Shalan, Manager of the Fertility Care Unit, Mansoura University, for his invaluable effort during both the conduction of the trial and follow-up of pregnancy outcomes, enabling completion of this trial report.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Mansoura University, Mansoura, Egypt

    Muhammad Fawzy & Abdel-Aziz A. El-Refaeey

Authors
  1. Muhammad Fawzy
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  2. Abdel-Aziz A. El-Refaeey
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Correspondence to Muhammad Fawzy.

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Fawzy, M., El-Refaeey, AA.A. Does combined prednisolone and low molecular weight heparin have a role in unexplained implantation failure?. Arch Gynecol Obstet 289, 677–680 (2014). https://doi.org/10.1007/s00404-013-3020-8

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  • DOI: https://doi.org/10.1007/s00404-013-3020-8

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