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Dexamethasone for Miscarriage Prevention May Adversely Impact Fetal Development

FertilityAuthority,  Jan 16, 2013

January 16, 2013

Do the benefits of Dexamethasone, or "Dex", for miscarriage prevention outweigh the potential risks to your unborn child? The data is inconclusive.

Dexamethasone has been prescribed off-label by some fertility clinics to IVF patients presumed to have immune disorder-related pregnancy loss in order to reduce their risk of miscarriage. The idea is to “turn off” that biological function to allow the pregnancy to continue growing, but it turns out there is not significant scientific support that Dex’s supposed benefit (preventing miscarriage) outweighs its potential risks (health complications to the child).

The corticosteroid is an FDA Category C drug and has been proven to cross into the placenta, which could impact the development of the fetus in the first trimester. In fact, physicians have prescribed Dex to mothers at risk of a premature birth specifically because it is known to impact the development of the fetus (speeds up lung development in the third trimester). A Swedish study published in the Journal of Clinical Endocrinology and Metabolism, examined Dex as a treatment for an endocrine disorder and discovered adverse events in offspring. However, it is unclear if the drug was the cause of these cognitive and physical impairments.

Perhaps most disconcerting is that the frequency of miscarriage as a result of an immune disorder is unknown, though presumed rare, and Dex data on its ability to prevent miscarriage or effects on the unborn fetus is simply not available.

Especially given the recent link between prenatal exposure to DES (the Dex of our mothers’ generation) and infertility or cancer in those offspring, we’re left to wonder if it is worth the risk.

While there isn’t conclusive evidence to prove Dexamethasone will cause infertility or cancer in children born of IVF, fertility patients must understand that potential risks do exist and could outweigh the benefits of using the drug. It is important to research and advocate for your own care. Above all, if you feel uncomfortable with a prescribed treatment, talk to your fertility doctor and arrive at a course of treatment you can agree upon.


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