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.