From the Guidelines
Intranasal steroid sprays can be safely used during IVF treatment, and it is recommended to continue using the prescribed nasal steroid spray, such as fluticasone, mometasone, or budesonide, while undergoing fertility treatments. These medications have minimal systemic absorption, making them unlikely to interfere with fertility medications or embryo implantation 1. The typical dosing is 1-2 sprays in each nostril once or twice daily, depending on the specific medication prescribed.
Key Considerations
- Intranasal corticosteroids, including budesonide, have a Pregnancy Category B rating, indicating that they are safe to use during pregnancy, with extensive human safety data available 1.
- A recent meta-analysis concluded that the use of intranasal corticosteroids during pregnancy does not increase the risk of major malformations, preterm delivery, low birth weight, and pregnancy-induced hypertension 1.
- It is essential to inform your reproductive endocrinologist about all medications you're taking, including over-the-counter products, to ensure there are no specific concerns related to your individual treatment protocol.
Safety Profile
- The safety profile of intranasal steroids during IVF stems from their limited systemic absorption—less than 1% of the dose typically enters the bloodstream, which is insufficient to affect hormone levels or reproductive processes 1.
- If you're concerned about any potential interactions, it's best to use the nasal spray at least 30 minutes before or after any fertility medications administered nasally.
Recommendations
- Continue using your prescribed nasal steroid spray while undergoing fertility treatments.
- Inform your reproductive endocrinologist about all medications you're taking.
- Use the nasal spray at the lowest effective dose, and follow the recommended dosing schedule.
From the Research
Intranasal Steroid Spray and IVF
- There is no direct evidence in the provided studies regarding the relationship between intranasal steroid sprays and IVF.
- However, the studies discuss the safety and efficacy of intranasal steroid sprays during pregnancy 2, 3.
- One study suggests that intranasal corticosteroid sprays, such as fluticasone furoate, mometasone, and budesonide, are safe to use during pregnancy if used at the recommended therapeutic dose after a proper medical evaluation 2.
- Another study discusses the safety profile of intranasal steroid sprays, including their use in special populations, but does not mention IVF specifically 3.
- The other studies focus on the efficacy and safety of specific intranasal steroid sprays, such as fluticasone propionate 4, 5 and fluticasone furoate 6, in the treatment of rhinitis, but do not address their use in relation to IVF.
Safety of Intranasal Steroid Sprays
- The studies suggest that intranasal steroid sprays are generally safe and well-tolerated, with few significant local or systemic side effects 2, 4, 3.
- However, it is recommended to use these sprays at the lowest effective dose and to monitor patients regularly, especially in special populations such as children and those with certain medical conditions 3.
- The use of intranasal steroid sprays in combination with other medications, such as topical antihistamines, may be effective and safe, but should be approached with caution and under medical supervision 5.