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Abstract
Corticosteroids in IVF – Benefits and Risks: Corticosteroids like prednisolone and dexamethasone are utilized in IVF to enhance implantation by suppressing maternal immune responses and reducing uterine inflammation. While effective for patients with recurrent failure or autoimmune disorders, their use remains controversial due to significant maternal and fetal complications. Fetal risks include Intrauterine Growth Restriction (IUGR), neonatal adrenal suppression, and congenital anomalies such as orofacial clefts or clubfoot. Furthermore, steroids can weaken the amniotic sac’s collagen structure, increasing the risk of Premature Rupture of Membranes (PROM) and neonatal sepsis.
Maternally, prolonged use is associated with gestational diabetes, hypertension, and Cushingoid features like fluid retention and weight gain. Paradoxically, inappropriate steroid levels can disrupt the hormonal balance needed to sustain pregnancy, potentially leading to miscarriage. Due to these risks, safer immunomodulatory alternatives including IVIG, Tacrolimus, Hydroxychloroquine, and Intralipid therapy are increasingly preferred. When combined with nutritional support (Vitamin D, Omega-3s) and anti-inflammatory lifestyle adjustments, these alternatives aim to improve reproductive success while prioritizing maternal-fetal safety and reducing systemic side effects.