Old habits die hard: retrospective analysis of outcomes with use of corticosteroids and antibiotics before embryo transfer.

OBJECTIVE: To evaluate clinical pregnancy rates in embryo transfer (ET) cycles with and without peri-implantation corticosteroid and oral antibiotic administration.

DESIGN: Retrospective cohort study.

SETTING: University-affiliated in vitro fertilization (IVF) clinic.

PATIENT(S): Eight hundred and seventy-six ETs with or without the routine use of methylprednisolone and doxycycline.

INTERVENTION(S): Embryo transfer procedures.

MAIN OUTCOME MEASURE(S): Clinical pregnancy rates (CPR).

RESULT(S): The CPR with the routine use of methylprednisolone and doxycycline was 56.1% compared with 61.5% after discontinuation of these medications. Ongoing pregnancy rates were 49.5% with medications versus 53.2% without medications. Of the cleavage-stage embryos, 79% underwent assisted hatching; among these, the CPR was 28.7% when treated with corticosteroids and antibiotics compared with 47.4% without medications.

CONCLUSION(S): No statistically significant difference in overall IVF outcomes was noted after the discontinuation of routine peri-implantation corticosteroids and antibiotics. The use of these medications varies across the country and may be a result of habit rather than evidence-based medicine.