Prednisolone – the fertility wonder drug?
When it comes to fertility medication, some are more controversial than others. A steroid called Prednisolone, marketed as Prednisone in a few countries, is one of them. Some call it a fertility wonder drug. Others are more sceptical. So is it worth trying or a waste of money? Let’s look at the evidence.
Prednisolone is a form of corticosteroid that is sometimes prescribed to women with recurrent miscarriage and/or elevated natural killer (NK) cells. It’s also given to men to reduce the production of anti-sperm antibodies (which, like NK cells, may not be as scary as they sound). Prednisolone is basically a synthetic hormone that helps suppress immune responses.
Prednisolone isn’t just prescribed to fertility patients. Its anti-inflammatory and immuno-suppressive abilities can treat a range of other conditions, including allergies, blood disorders, respiratory problems and skin problems.
But while Prednisolone is well regarded in general medicine, the jury is out on its benefits to fertility patients. Lord Winston, for example, is distinctly wary of it. We’ve seen a few studies of Prednisolone’s alleged role in reducing the risk of miscarriage and the ‘threat’ from natural killer cells (cells that may attack the fetus). But most are small-scale. As yet, no extensive trials have been conducted.
An Australian study used low-dose Prednisolone alongside blood-thinner Clexane to try to suppress natural killer cells in women with recurrent miscarriages. The results were quite promising. But the number of participants involved was minimal, making it hard to draw firm conclusions.
And a 2014 update of a Cochrane Review into immunotherapy for recurrent miscarriage had to exclude a number of studies into Prednisolone from analysis. They didn’t meet the exacting standards required.
When prescribed to female fertility patients, Prednisolone is used for a relatively short period of time. Doses vary, but 5 mg a day is common. Be wary if your clinic increases that daily dose, especially if it goes above 20 mg. Prednisolone pills are normally started on egg retrieval day. But patients with elevated NK levels, or a pattern of implantation failure after fertility treatments, may be put on the drug when they start their stimulating medication. That’s around two weeks earlier.
If your HCG blood test is negative, your fertility medication, including Prednisolone, will be stopped. If it’s positive, you’ll probably be told to continue until you’re 12 weeks pregnant. Your dosage may be gradually reduced.
Like any drug, there are risks involved with taking steroids. Common side effects of Prednisolone include irritability, anxiety and sleep disturbance. Taking corticosteroids in pregnancy could also affect fetal growth. We can only hope the claimed benefits are worth that risk.
Deciding whether or not to try a fertility drug like Prednisolone is not easy. On the one hand, there’s hope it could be your miracle cure. On the other, it may be a dead end. Unlike intralipid infusion therapy (another NK-cell treatment with limited evidence it really works) Prednisolone is at least quite cheap. It doesn’t feel like an expensive extra hoisted on you by a cash-hungry clinic.
If you’ve been recommended Prednisolone, give it careful thought. Talk to your GP and clinic. Make sure you’re fully aware of what’s involved and the implications for and against the treatment. The success stories on the fertility forums may sound enticing. But there’s no guarantee it will work for you. And until a large-scale, randomised, controlled trial is carried out, the situation remains unclear.
Alextwin
Hello.
I’m actually in 10 week pregnancy and 8 week after I conceive and currently taking 20 mg predninsolone.I know that I should take two weeks more but after that should decrease 5 Mg per day said my doctor.It’s it ok?He don’t told me that I should decrease all the pills
Lynne Matthews
30 years ago I went to an Endocrinologist who specialized in Infertility. He looked at my ovulation temperature charts, and put me on Prednisolone 2.5mg a day and I became pregnant within 3 months. Three years later I went back on same dose and got pregnant the first month.
Lauren Neuenschwander
do you mind me asking how long you stayed on it and if your dose changed? thanks
Christine
I am on my way to Greece to have a donar egg implanted. I am on Prednisolone as well has having intralipid infusions. This is my 5 time so am hoping is all works this time
Lyn scott
2nd round of ivf. This time prescribed predisinfection, aspirin, estrofem and progesterone but not folic acid. Just wondering whether it is still OK to take the pregnacare vitamin and folic acid supplements?
Sharon
To the ladies above who are on the steroid, what dose are you on each day?
Cheers
J
It mentions that it may affect foetal growth…in what way?
It seems to leave more questions that it answers.
Can anyone help me with this please?
Nelly
Hi just finished my second try of IVF blastocyst, was unsuccessful, can’t understand why cos my first try I fell pregnant but had miscarriage, didn’t know about Prednisone and wondering how new is this therapy as my doctor never suggested it. Wondering if I should go for another cycle!
Pagan
I have been trying to conceive for 10 years now, I have pcos, I have never received any fertility treatment, nor have I ever been pregnant, that was until December 2016 when I fell pregnant whilst taking prednisone, sadly that pregnancy ended in miscarriage at 8 weeks. I was only in Prednisone for 10 days for a chest infection so I never expected it would help me get pregnant. I have told my doctor that when I got pregnant I was on prednisone but they refuse to prescribe it me and they are well aware of my struggle to get pregnant. I have not been able to get pregnant since, no offer of help or any interest from Doctors of my fertility. If ever there comes up any trials to help women get pregnant on prednisone then I would happily put myself forward for it. I am saving up for surrogacy but if I can get pregnant naturally by taking prednisone then I would happily go for
It
Jane
I’m confused by your comment. You said you’ve never had fertility treatment. Wouldn’t that be the first step, rather than jumping to surrogacy???
Dr.Devendra
Hi pagan,
M Dr Devendra from India.
I m a gynecologist ..I want to tell u one thing if u have got pregnant once half d battle u have won…it means there is nothing wrong in d process of fertilization and implantation ..only thing is, u have to continue it till term…which includes lot of things like ur age, normal uterine structure, hormonal level in body, h/o any infection and nutrition…once all dis factors work well der shudnt b a problem to make it reach till term….wish u a good luck.
Jen
Don’t take no for an answer. If your FS refuses to prescribe it, tell them you’re going to look for an FS who will. Your family doctor could also prescribe it,
These doctors just don’t get it, a lot of the time we know what’s best for our bodies.
You have to be courageous and be bold 🙂
Trust your instincts and read loads of success stories from reading various fertility forums.
The use of prednisone and baby aspirin and Lovenox has been a game changer for so many women with failed attempts including myself. There’s no real harm & if it works great 🙂
Ashley
My Fertility doc has put me on it after egg retrieval. If you go to a fertility doctor they will prescribe it. So far I’m supposed to be on it until I do my pregnancy test in a week after transfer. You can also request it for other reasons like skin conditions and allergies. Then just try to get pregnant. Supposedly it’s taken up to week 12 only. They also have me on progesterone pills (5 /day) and some other estrogen to support the uteraean lining. Also if you’re Rh – and your partner if Rh positive it’s common for your body to attack the Cetus and kill it and miscarry. You can get the rho gham injection so you won’t kill his Sperm or the Cetus and this prevents rh miscarriage. Don’t give up! Also seeing a naturopath that specializes in Fertility will help. The longer you wait the less likely you’ll get pregnant so explore a fertility clinic now or freeze some eggs. Good luck dear 🙂
Tressie
I am currently taking prednisone 20mg tablets. Is this safe? Per tour article, it states “no more than 20mg”. I have been married 16yrs, and we have been trying for 14yrs to conceive, been on numerous cycles of Clomid, had a couple of Hysterosalpingogram done, had my uterus and ovaries checked with ultrasound, every test an procedure I have done have all come back normal. Only explanation I have been given, unexplainable, but see nothing wrong for us to conceive. Last year we visited with a fertility specialist, and we will need to come up with about $750 to begin fertility treatment. In conclusion, can I continue with taking and finishing the prednisone that I am on, and engage in intercourse with my husband? This week I should be ovulating, according to the period diary app I use.
Abigail
I’ve been prescribed this drug twice along with clomiphene citrate. I got a month’s worth of the prednisone but I didn’t finish them (stopped last friday). I was not made aware by my gynecologist that this was a steroid nor the side effects until I researched. I plan on going to another as there has to be a better and safer option.
Ren
Hello , i just wondering this is right that doctor after IVF tell me to take 2 time a day prenisolone and how this tablets can effect my pregnacy ?
Scared
Hi Ren, just wondering how are you doing with your IVF? I’m waiting for my BETA result today (blood withdrawn yesterday), and for the past 14 days been taking Prednisone twice a day. IVF 5th day blastocyst FET. Thanks.