Administration of prednisolone and low molecular weight heparin in patients with repeated implantation failures: a cohort study

Gynecol Endocrinol. 2018 Feb;34(2):136-139. doi: 10.1080/09513590.2017.1380182. Epub 2017 Sep 26.

Abstract

Conflicting results exist for low molecular weight heparin (LMWH) and prednisolone when tested as separate adjuncts for the improvement of the clinical outcomes in patients with repeated implantation failures (RIF) undergoing IVF/ICSI treatment. Through a cohort study, we evaluated the combined effect of both drugs on pregnancy parameters in 115 women with RIF. Clinical pregnancy rate was the primary end point while the sample size was calculated through the results of a pilot study. Clinical and IVF cycle characteristics were also compared between the groups. Baseline and cycle characteristics were comparable between groups. Biochemical and clinical pregnancy rates were similar in both groups [23/57 (40.4%) vs. 14/58 (24.1%), and 17/57 (29.8%) vs. 11/58 (19%), p = .063, and .175, respectively]. Similarly, miscarriage rates were comparable between the groups (35.7% vs. 34.8%), as well as live birth rates [15/57 (26.3%) vs. 9/58 (15.5%), p = .154]. In conclusion, the administration of LMWH with prednizolone in subfertile women with RIF seems not to improve clinical pregnancy rates, but a full-scaled RCT would definitely be more accurate.

Keywords: Assisted reproductive techniques; low molecular weight heparin; prednisolone; pregnancy rates; recurrent implantation failure.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Cohort Studies
  • Combined Modality Therapy / adverse effects
  • Drug Therapy, Combination / adverse effects
  • Egypt / epidemiology
  • Family Characteristics
  • Female
  • Fertility Agents, Female / adverse effects
  • Fertility Agents, Female / therapeutic use*
  • Fertilization in Vitro
  • Glucocorticoids / adverse effects
  • Glucocorticoids / therapeutic use*
  • Heparin, Low-Molecular-Weight / adverse effects
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Hospitals, University
  • Humans
  • Infertility, Female / drug therapy*
  • Infertility, Female / therapy
  • Infertility, Male
  • Intention to Treat Analysis
  • Male
  • Outpatient Clinics, Hospital
  • Ovulation Induction* / adverse effects
  • Prednisolone / adverse effects
  • Prednisolone / therapeutic use*
  • Pregnancy
  • Pregnancy Rate
  • Retrospective Studies

Substances

  • Anticoagulants
  • Fertility Agents, Female
  • Glucocorticoids
  • Heparin, Low-Molecular-Weight
  • Prednisolone