Prednisolone plus low-dose aspirin improves the implantation rate in women with autoimmune conditions who are undergoing in vitro fertilization

Objective: To evaluate the effect of prednisolone plus low-dose aspirin (PSL/LDA) in women with autoimmune conditions who were enrolled in an IVF-ET program. Design: A retrospective clinical study. Setting: In vitro fertilization unit, Niigata University Hospital, Niigata, Japan. Patient(s): Three hundred seven women who underwent IVF-ET between January 1996 and December 1997. Intervention(s): Prednisolone (10 mg/d) and aspirin (81 mg/d) were administered to the women with autoantibodies who chose to participate. Main Outcome Measure(s): Pregnancy and implantation rates with IVF-ET. Result(s): Women undergoing IVF who had positive antinuclear antibodies,with or without antiphospholipid antibodies, had significantly lower pregnancy and implantation rates than did women without autoantibodies (14.8% versus 21.7% and 6.8% versus 10.4%, respectively). The administration of PSL/LDA to women with antinuclear antibodies significantly improved the outcome of IVF-ET (40.6% pregnancy rate and 20.3% implantation rate). Conclusion(s): A high proportion of women who are undergoing IVF-ET have autoantibodies, which are associated with poor IVF outcomes. The administration of PSL/LDA to these women may improve their implantation rate. (Fertil Steril(R) 1998; 70:1044-8. (C) 1998 by American Society for Reproductive Medicine.)