Spironolactone use and oocyte maturation in patients undergoing controlled ovarian hyperstimulation

J Assist Reprod Genet. 2024 Aug;41(8):1991-1996. doi: 10.1007/s10815-024-03214-6. Epub 2024 Jul 26.

Abstract

Purpose: To evaluate the association between spironolactone use and controlled ovarian hyperstimulation (COH) outcomes.

Methods: Retrospective study, including patients who underwent COH. Oocyte yield and maturation rates were compared by categories of spironolactone use at the start of their cycle.

Results: 402 patients were included. 83 patients continued spironolactone, 44 patients discontinued spironolactone, and 275 matched control patients were spironolactone-naïve. No difference was observed in the number of oocytes retrieved (17 ± 14 vs. 15 ± 13, p = 0.4) or mature oocytes vitrified (15 ± 9.5 vs. 12 ± 11, p = 0.4) in patients who continued spironolactone use and spironolactone naïve patients, respectively. When comparing patients who continued spironolactone use and patients who discontinued spironolactone use, no difference was seen in the number of oocytes retrieved (17 ± 14 vs. 17.5 ± 7.8, p = 0.9) or mature oocytes vitrified (15 ± 9.5 vs. 13.5 ± 6.5, p = 0.5), respectively. There was no observed relationship between total daily spironolactone dose (< 100mg/day, 100mg/day, 150mg/day and > 200 mg/day) and the total number of mature oocytes vitrified (respectively, 14.0 ± 13.0, 16.0 ± 7.8, 14.0 ± 4.5, 11.0 ± 7.0 oocytes, p = 0.4).

Conclusions: This is the first study to evaluate the association between spironolactone and oocyte yield and maturation rates during COH cycles. These findings can assist in counseling patients on the implications of continuing spironolactone during COH cycle.

Keywords: Aldactone; Controlled ovarian hyperstimulation; Fertility preservation; Oocyte cryopreservation; Spironolactone.

MeSH terms

  • Adult
  • Female
  • Fertilization in Vitro / methods
  • Humans
  • In Vitro Oocyte Maturation Techniques / methods
  • Oocyte Retrieval* / methods
  • Oocytes* / drug effects
  • Oocytes* / growth & development
  • Ovulation Induction* / methods
  • Pregnancy
  • Pregnancy Rate*
  • Retrospective Studies
  • Spironolactone* / administration & dosage
  • Spironolactone* / therapeutic use

Substances

  • Spironolactone