High-dose, short-term glucocorticoids for the treatment of infertility resulting from premature ovarian failure.

OBJECTIVE

To evaluate prospectively the effects of high-dose, short-term treatment with a glucocorticoid in an attempt to normalize ovarian failure and induce pregnancy in women presenting with infertility.

DESIGN

Uncontrolled, nonrandomized prospective study.

SETTING

Two university-based reproductive endocrinology clinics.

PATIENTS: Eleven consecutive women with premature ovarian failure (POF) who were desirous of pregnancy.

INTERVENTIONS: Prednisone 25 mg four times per day for 2 weeks.

MAIN OUTCOME MEASURES: Two women demonstrated normalization of their serum gonadotropins, an increase of serum E2, and ultrasonographic visualization of follicular growth, with both conceiving. The other nine demonstrated no biochemical or clinical response.

CONCLUSIONS

Premature ovarian failure may not be an irreversible process and may either spontaneously resolve or may respond to therapeutic modalities such as high-dose glucocorticoids in selected patients. In this uncontrolled study, the results were best with women with concomitant autoimmune thyroid disease and POF of < 2 years' duration.