Impact of low-dose dexamethasone on pregnancy outcome in type A PCOS women candidate for IVF/ICSI using the gonadotropinreleasing hormone antagonist protocol

Abstract

Objective. Evaluation of the efficacy of low-dose dexamethasone on ovarian response and pregnancy outcome in infertile patients with type A polycystic ovarian syndrome (PCOS). Patients and methods. The study included infertile patients with type A PCOS who were candidates for in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) using a fixed GnRH antagonist protocol. The patients were randomized into two groups: a low-dose steroid group of 80 women with type A PCOS undergoing a trial of IVF/ICSI who received two tablets of 0.5 mg dexamethasone every evening from the first day of gonadotropin administration till the night before oocyte retrieval with a GnRH antagonist controlled ovarian hyperstimulation (COH), and a placebo group of 80 women with type A PCOS undergoing IVF/ICSI who received two tablets of placebo from the first day of gonadotropin administration until the night of oocyte retrieval. Results. In the low-dose dexamethasone group, the duration of stimulation was statistically significantly shorter, and there were significantly fewer stimulation ampoules; however, E2 levels on the day of ovulation induction, fertilization rate, and the number of retrieved M2 and fertilized oocytes were significantly higher compared to the placebo group. On the other hand, there was no significant difference between both groups regarding the incidence of ovarian hyperstimulation syndrome (OHSS) and the rate of embryo transfer. Conclusion. Dexamethasone improves embryo quality and pregnancy rate; additionally, it minimizes the number of gonadotropin ampoules used for stimulation. Thus, we suggest the use of dexamethasone in women with PCOS undergoing IVF/ICSI treatment. Key words: low-dose dexamethasone; type A PCOS; IVF/ICSI; antagonist protocol