Corticosteroid use before embryo transfer improves ART success in women with RA, IBD

Among women with rheumatoid arthritis (RA) and/or inflammatory bowel disease (IBD) undergoing assisted reproductive technology (ART) procedures, embryo transfer at the blastocyst stage and corticosteroid use prior to ART appear to improve chances of a live birth, a study has found.

The study used data from nationwide Danish health registries and included 1,824 embryo transfers in women with RA/IBD and 97,191 embryo transfers in women without RA/IBD (controls). Successful ART was defined as a live birth per fresh embryo transfer.

Results showed that compared with controls, women with RA/IBD receiving ART had lower odds of having a live birth (adjusted odds ratio [OR], 0.79, 95 percent confidence interval [CI], 0.68–0.91).

Of note, certain medications used to treat RA or chronic IBD favourably influenced the success of ART. Specifically, prescribed corticosteroids before embryo transfer were positively associated with a live-born child (adjusted OR, 1.21, 95 percent CI, 1.12–1.31), while the use of anti-inflammatory or immunosuppressive agents did not have significant importance.

With regard to ART procedures, intracytoplasmic sperm injection was associated with a lower success of a live birth (adjusted OR, 0.94, 95 percent CI, 0.90–0.97). On the other hand, transfer at the blastocyst stage was associated with increased chances (adjusted OR, 1.54, 95 percent CI, 1.46–1.62), while type of hormone treatment protocol had a null effect.