Prednisolone Improves IVF Outcomes in Men With Anti-sperm Antibodies
Status:
Completed
Trial end date:
2016-05-01
Target enrollment:
Participant gender:
Summary
Corticosteroids have been indicated to treat men with ASAs. Although many studies have
confirmed the clinical therapeutic significance of corticosteroids in the treatment of men
with ASAs, other studies have not found a therapeutic significance for corticosteroids in the
treatment of men with ASAs. Moreover, although some reports have shown high fertilization and
conception rates in couples when husbands did not have ASAs, other reports have shown that
ASAs do not have a negative effect on fertilization and conception rates. These contradictory
results have left the therapeutic effect of corticosteroids in men with ASA in continuing
controversy. This controversy is also extended to include the usefulness of assisted
reproductive technology (ART) in the treatment of patients with ASAs. In this regard,
although some studies have shown that the pregnancy rate following in vitro fertilization
(IVF) or intracellular sperm injection (ICSI) were similar in men with or without ASA or did
not associate with ASA, others reported the superiority of ICSI over IVF and intrauterine
insemination over natural intercourse in men with ASAs. It is possible that some patients
with ASAs also have an additional problem(s) related to sperm binding to the oolemma and
fusion into the ovum as well as sperm head decondensation. The latter condition may
negatively influence or mask the clinical significance of corticosteroids on pregnancy rates
in patients with ASAs. Some patients might not have benefited from corticosteroids and
conventional IVF treatments due to the impaired sperm fusogenic capacity in addition to ASAs.
Human sperm penetration assay (SPA), of the hamster oocyte free from zona pellucida, is a
sensitive tool that can address such potential impairment of sperm binding with the oolemma
and fusion into the oocyte as well as sperm head decondensation. Males with poor SPA results
benefit from ICSI whereas those with good SPA results can still benefit from conventional
IVF.
The present study was therefore conducted to address the therapeutic usefulness of a
corticosteroid named prednisolone in the treatment of immunologically infertile men
undergoing IVF or ICSI determined by SPA.
Phase:
N/A
Details
Lead Sponsor:
Barz IVF Center for Infertility Treatment and Embryo Research