Dexamethasone vs. Prednisone during IVF

erosybelle

11 Posts
Reply Posted on: Apr 18, 2012 at 4:29pm
Dear Dr. Braverman,

We are planning an IVF cycle soon - we tested with you, and I have Hashimoto's with high ATAs and moderately positve ANA and APAs, and positive MTHFR.

I'm reading in immune forums that some women start Dexamathasone the month before IVF. The clinic here is recommending Dexamethasone over Prednisone. What's the difference between them, when should you start them, and what dosages are generally prescribed?

You had suggested a protocol of intralipids, Prednisone, and Lovenox for me.

The RE at our clinic says that he would normally prescribe only .05mg of dexamethasone and 30mg of Lovenox, starting Lovenox only after egg retrieval.

Are there specific reasons to use Dexamethasone vs. Predisone in certain conditions?

Thank you so much,
Nora Cage

Dr. Braverman

2026 Posts
RE: Dexamethasone vs. Prednisone during IVF Posted on: Apr 18, 2012 at 5:41pm
Prednisone is better for pregnancy as it is broken down by the placenta and only minimal amounts cross the placenta to the baby, this is not the case with Dex. Dex at the dose you are taking is not for immune issues, just the usual dose given during IVF cycles that has shown to improve outcome in women without immune issues(activates certain enzymes and increases BHCG production) but with less side effects. Prednisone has the same actions some more side affects but again as our patients usually are on the prednisone until early in the pregnancy it is a better choice.
Dr. Jeffrey Braverman MD FACOG
Medical Director
Braverman Reproductive Immunology P.C.