דקסטמזון והפרייה חוץ גופית

1. המחשבה היא שהדקסמטזון מפחית את יצור ההורמונים הזכריים (אנדרוגנים) על ידי בלוטת יותר הכליה (האדרנל) וכך בעיקר משפר את איכות הביציות. או את התגובה להשראת ביוץ. 2. לנשים המתאימות התשובה היא כן, אבל המחקרים לא רבים וסביר שזה לא מועיל למרבית המטופלות. ראי למשל: Low-dose dexamethasone augments the ovarian response to exogenous gonadotrophins leading to a reduction in cycle cancellation rate in a standard IVF programme. Keay SD, Lenton EA, Cooke ID, Hull MG, Jenkins JM. Hum Reprod 2001 Sep;16(9):1861-5 University of Warwick, School of Biological Sciences, Gibbet Hill Road, Coventry CV4 7AL, UK. [email protected] BACKGROUND: Cancellation of assisted conception cycles because of poor ovarian response to gonadotrophins is a significant problem in assisted reproduction. Various adjuvant treatments have been suggested to improve responsiveness. This study reports on the potential benefits of low dose dexamethasone. METHODS: Patients <40 years of age were invited to participate in a twin centre prospective double blind randomized placebo controlled study. A total of 290 patients were recruited and computer randomized using sealed envelopes to receive either 1 mg dexamethasone (n = 145) or placebo tablets (n = 145) in addition to a standard long protocol gonadotrophin-releasing hormone analogue with gonadotrophin stimulation regime. RESULTS: A significantly lower cancellation rate for poor ovarian response was observed in the dexamethasone group compared with controls (2.8 versus 12.4% respectively, P < 0.002). Further comparisons between the dexamethasone group and controls were made of median fertilization rates (60 versus 61% respectively, NS), implantation rates (16.3 versus 11.6% respectively, NS) and pregnancy rate per cycle started (26.9 versus 17.2%, NS). The benefit was apparent in patients both with polycystic and normal ovaries. CONCLUSION: Low dose dexamethasone co-treatment reduces the incidence of poor ovarian response. It may increase clinical pregnancy rates and should be considered for inclusion in stimulation regimes to optimize ovarian response.