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在常规体外受精/胚胎移植患者中,皮质类固醇诱导的免疫抑制对妊娠率没有影响。

Immunosuppression by corticosteroid has no effect on the pregnancy rate in routine in-vitro fertilization/embryo transfer patients.

作者信息

Lee K A, Koo J J, Yoon T K, Do B R, Ko J J, Cha K Y

机构信息

Infertility Medical Centre, CHA General Hospital, Seoul, Korea.

出版信息

Hum Reprod. 1994 Oct;9(10):1832-5. doi: 10.1093/oxfordjournals.humrep.a138343.

Abstract

Immunosuppression by exogenous corticosteroids has been used to improve the rates of embryo implantation and pregnancy in in-vitro fertilization (IVF) patients who have micromanipulated embryos replaced. The present study was conducted, in a prospective design, to evaluate effects of corticosteroid on the pregnancy rate in IVF/embryo transfer patients who have non-micromanipulated embryos replaced. Infertile women < 40 years old with tubal factor were included in this study. Patients were grouped according to the different follicle stimulation protocols, and received various doses of 16 beta-methylprednisolone (0, 16 or 60 mg/day) for 4 days from the day of oocyte retrieval. The mean age, duration of infertility, length of folliculogenesis and serum oestradiol concentrations at the time of human chorionic gonadotrophin (HCG) injection were not significantly different between control and corticosteroid-treated groups of patients. Short-term immunosuppression by 16 beta-methylprednisolone administration did not show any effects on the pregnancy and miscarriage rates in IVF/embryo transfer patients. Also, immunosuppression showed no dose effects in any groups. There was no relationship between the types of follicle stimulation protocols and the effect of 16 beta-methylprednisolone. Therefore, we concluded that short-term immunosuppression by exogenous corticosteroids in IVF/embryo transfer patients who have embryos with intact zona pellucida replaced has neither positive nor negative effects on pregnancy rates.

摘要

外源性皮质类固醇的免疫抑制作用已被用于提高接受显微操作胚胎移植的体外受精(IVF)患者的胚胎着床率和妊娠率。本研究采用前瞻性设计,旨在评估皮质类固醇对接受非显微操作胚胎移植的IVF/胚胎移植患者妊娠率的影响。本研究纳入了年龄小于40岁、因输卵管因素导致不孕的女性。患者根据不同的卵泡刺激方案分组,从取卵日起连续4天接受不同剂量的16β-甲基泼尼松龙(0、16或60mg/天)治疗。对照组和接受皮质类固醇治疗的患者组在平均年龄、不孕持续时间、卵泡生成长度以及注射人绒毛膜促性腺激素(HCG)时的血清雌二醇浓度方面无显著差异。16β-甲基泼尼松龙的短期免疫抑制对IVF/胚胎移植患者的妊娠率和流产率没有任何影响。此外,免疫抑制在任何组中均未显示出剂量效应。卵泡刺激方案的类型与16β-甲基泼尼松龙的作用之间没有关系。因此,我们得出结论,对于接受完整透明带胚胎移植的IVF/胚胎移植患者,外源性皮质类固醇的短期免疫抑制对妊娠率既无正面影响也无负面影响。

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