Prednisone vs Placebo and Live Birth in Patients With Recurrent Implantation Failure Undergoing In Vitro...

Area of Science:

• Reproductive Medicine
• Clinical Trials
• Pharmacology

Background:

• Recurrent implantation failure is a significant obstacle in in vitro fertilization (IVF).
• Prednisone is often used to improve implantation and pregnancy rates, but evidence supporting its efficacy is limited.
• Immune-regulatory agents like prednisone are explored to overcome implantation barriers.

Purpose of the Study:

• To evaluate the efficacy of 10 mg of prednisone versus placebo in achieving live birth among women with recurrent implantation failure.
• To assess the impact of prednisone on key pregnancy outcomes in a challenging IVF population.

Main Methods:

• A double-blind, placebo-controlled, randomized clinical trial was conducted across 8 fertility centers in China.
• 715 women with a history of at least two failed embryo transfers were randomized to receive either 10 mg of prednisone or a placebo daily.
• The primary outcome measured was live birth, defined as delivery at or after 28 weeks' gestation.

Main Results:

• No significant difference in live birth rates was observed between the prednisone group (37.8%) and the placebo group (38.8%).
• Prednisone use was associated with a higher incidence of biochemical pregnancy loss (17.3% vs 9.9%) and preterm delivery (11.8% vs 5.5%).
• No significant differences were found in clinical pregnancy, implantation rates, neonatal complications, or congenital anomalies between the groups.

Conclusions:

• Treatment with prednisone does not enhance live birth rates in women experiencing recurrent implantation failure.
• The findings suggest that prednisone may elevate the risks of biochemical pregnancy loss and preterm delivery.
• The routine use of prednisone for recurrent implantation failure warrants re-evaluation in clinical practice.