Corticosteroid Use Prior ART Procedure Improves Chances of Live Birth Among Women With Rheumatoid Arthritis and IBD

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

Corticosteroid Use Prior ART Procedure Improves Chances of Live Birth Among Women With Rheumatoid Arthritis and IBD
Photo: Artificial Insemination | InStyleHealth


What Are Corticosteroids?

Corticosteroids are a group of medicines that lowers the inflammation in the body. These group of medicines will reduce the immune system activity.

Corticosteroids will ease swelling, itching, redness, and allergic reactions, medical health professionals often prescribe this medicine in treating the following diseases:

  • Allergies
  • Arthritis
  • Asthma
  • Lupus

Corticosteroids are similar to cortisol which is a hormone naturally produced by the body’s adrenal glands. A human body needs cortisol to remain healthy, because cortisol serves as a major player in several processes in the body such as, metabolism, immune response, and stress.

What Is An Assisted Reproductive Technology or ART Procedure?

Assisted Reproductive Technology or ART procedure is defined as the technology that includes all fertility treatments in which either eggs or embryos are handled. It is the procedure that uses donor or non-donor eggs and sperm to create embryos in vitro.

Generally, an ART procedure involves surgically removing the egg from a woman’s ovaries, combining them with the sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. The procedure does not include treatments in which only the sperms are handled or procedure in which a woman takes medicine only to stimulate egg production without the intention of having eggs retrieved.

Some examples of assisted reproductive technology or ART procedure includes: in vitro fertilization or IVF, gamete intrafallopian transfer or GIFT, and zygote intrafallopian transfer or ZIFT.

What Are The Advantages of Assisted Reproductive Technology?

A great advantage of assisted reproductive technology or ART procedure is achieving a successful pregnancy and birthing a healthy baby. ART can make this happen for people who are unable to having a baby in the natural way, otherwise, blocked tubes. For women with blocked or damaged fallopian tubes, undergoing an ART procedure can give the best opportunity of having a baby using their own egg cells.

What Are The Risks of Assisted Reproductive Technology?

Assisted Reproductive Technology or ART procedure includes the following risks:

  • Abruptio Placentae
  • Birth Defects
  • Cesarean Delivery
  • Low Birth Weight
  • Multifetal gestations
  • Perinatal Mortality
  • Placenta Previa
  • Preeclampsia
  • Prematurity
  • Small for Gestational Age

How Much Does Assisted Reproductive Technology Cost?

Medical cost associated with the assisted reproductive technology or ART procedure for 10,001 fresh autologous elective double ETs, is estimated to be at $15,715 per fresh cycle and $3,812 per frozen cycle.

Research utilized the data from nationwide Danish health registries and involved 1,824 embryo transfers in women with rheumatoid arthritis (RA) and inflammatory bowel disease (IBD), and 97,191 embryo transfers in women without RA and/or IBD (control group). A successful assisted reproductive technology or ART procedure was defined as a live birth per fresh embryo transfer.

Outcomes revealed that comparing with the control group, women with RA/IBD receiving ART had lower odds of having a live birth.

Notably, there are certain medications used to treat rheumatoid arthritis (RA) or chronic inflammatory bowel disease (IBD) the success of ART. Particularly, prescribed corticosteroids prior embryo transfer were positively correlated with a live-born child, while the use of anti-inflammatory or immunosuppressive agents did not have significant importance.

Regarding ART procedures, intracytoplasmic sperm injection was correlated with a lower success of a live birth.

Alternatively, the transfer at the blastocyst stage was correlated with increased chances, while type of hormone treatment protocol had a null effect.

 

Source: Fertil Steril 2021;doi:10.1016/j.fertnstert.2021.07.1198


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