Indomethacin effect on implantation rates in oocyte recipients.

Author(s): Bernabeu R, Roca M, Torres A, Ten J

Affiliation(s): Instituto Bernabeu, Alicante, Medical School, Murcia University and Reproductive Health Chair, Universidad Miguel Hernandez (Alicante), Spain.

Publication date & source: 2006-02, Hum Reprod., 21(2):364-9. Epub 2005 Nov 10.

Publication type: Randomized Controlled Trial

BACKGROUND: Implantation failure is the main limiting factor for success of IVF. Even when transfer techniques are carried out extremely carefully, embryo transfer may produce an endometrial and cervical reaction that may result in an inflammatory response and impaired implantation. There are no formal specifications on the use of indomethacin in reproductive cycles and there are no studies published in the scientific literature on its effect on embryo implantation. Oocyte donation is the best model to evaluate the determinants of implantation. The aim of this study is to evaluate the potential benefit of indomethacin administered at embryo transfer. METHODS: A randomized pilot trial of 136 oocyte recipients was carried out. Seventy-two women received standard specifications plus 100 mg of indomethacin rectally given as three doses every 12 h starting on the night prior to transfer. RESULTS: Positive HCG (>= 6 mUI/ml) occurred in 59.7% of treated women and in 59.4% of women in the control group. Implantation rates were 27.8% in the indomethacin group and 26.4% in the controls. CONCLUSIONS: The indomenthacin group did not show significantly higher implantation rates. A larger study exploring alternative treatment protocols might be appropriate.