In women with thyroid autoimmunity, does low-dose prednisolone administration, compared with no adjuvant therapy, improve in vitro fertilization clinical results?

Abstract

Aim: The objective of the study was to verify if prednisolone treatment may influence the in vitro fertilization (IVF) outcome in euthyroid women affected by thyroid autoimmunity.

Methods: One hundred and ninety-four patients including 60 positive for antithyroid antibodies (ATA) underwent the ovarian stimulation in the standard long protocol for IVF and 30 women received the low-dose prednisolone from the day of oocyte retrieval.

Results: The overall, clinical pregnancy and live birth rate in ATA-positive patients receiving prednisolone supplementation was significantly higher when confronted with ATA-positive untreated subjects (60.0% vs 30.0%, P = 0.02; 46.6% vs 16.6%, P = 0.03; and 46.6% vs 20.0%, P = 0.05, respectively). The same parameters in ATA-positive untreated women were significantly lower than in the controls (30.0% vs 50.7%, P = 0.0001; 16.6% vs 38.1%, P = 0.04; and 20.0% vs 40.3%, P = 0.04, respectively).

Conclusion: There is a strong association between the presence of thyroid autoantibodies and poor IVF outcome. The prednisolone co-treatment may improve the clinical pregnancy rate and reduce the miscarriage rate after IVF in women affected by thyroid autoimmunity.

Keywords: glucocorticoids; in vitro fertilization; miscarriage; pregnancy; thyroid antibodies.