Clinical results of microinjection with long protocol and prednisolone addition

Last decades, we have observed major improvements in treating infertility
by using microinjection. However, reduction in abortion or increase in fertility has not
been significant. It seems use of corticosteroids improves clinical outcomes during
assisted reproductive technology (ART) techniques. Therefore, this study tried to show
how corticosteroids therapy improves the results of intracytoplasmic sperm injection
(ICSI).
Methods: This semi clinical trial study without control group was included infertile
women with more than one year’s infertility and were candidate to ICSI which were referred
to Kosar Infertility Center, Urmia University of Medical Sciences from April 2011
to September 2013. Patients received prednisolone which was started 20 mg/day from one
day before embryo transfer to 7 days, then for 2 days more 1 tablet and stopped. Pregnancy
outcomes were chemical and clinical pregnancy, ectopic pregnancy, multiple pregnancy
and rate of abortion before 20 weeks. Beta human chorionic gonadotropin (HCG)
test was performed. Patients with positive pregnancy test were followed by sonography in
6, 12 weeks and 20 weeks of pregnancy.
Results: One hundred and eighty one patients entered to the study. The mean± SD of age
and fertility duration were 30.42± 6.07 and 7.69± 5.54 years. The mean± SD of transferred
embryo was 4.60± 1.10 and embryo grading was 138 (44.7%) grade A, 124
(40.1%) grade B, 47 (15.2%) grade C, respectively. There were no significant difference
between fresh/frozen embryo transfer in pregnancy outcomes (P> 0.05 in all of outcomes
comparison). The incidence rate of biochemical pregnancy was 48.1% (87), clinical pregnancy
rate with appearance of fetal heart was 44.2% (80), incidence rate of abortion before
appearance of fetal heart (6 weeks) in women with intra-uterine pregnancy was 5.9%
(5), incidence rate of abortion before 20 weeks was 12.9% (11). Incidence rate of ectopic
pregnancy was 2.3% (2) and rate of multiple pregnancies was 32.5% (26).
Conclusion: Our study suggests that the infertile patients who receive prednisolone in
ICSI cycle, had improved pregnancy outcomes. Additional confirmatory studies are
needed.