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Ruan X, Xu Z, Xu X, Yang Y, Cheng J, Luo S, Min M, Li M, Zhang L, Ju R, Jin F, Mueck AO. A prospective study on the endometrium properties and the pregnancy rate of infertile women with thin endometrium receiving Fructus ligustri lucidi used in traditional Chinese medicine. Gynecol Endocrinol 2023; 39:2249997. [PMID: 37624969 DOI: 10.1080/09513590.2023.2249997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/11/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE To evaluate whether Zi Gui Nv Zhen capsules (ZGNZC) can increase the fertility rate of Chinese women with infertility due to thin endometrium. METHODS Prospective, randomized, open-labeled 3-monthly study; 104 patients (aged 20-40 years) receiving either ZGNZC (experimental group, n = 55) or not (control group, n = 49). Main outcomes: thickness/type of the endometrium during ovulation and pregnancy rate. Between-group analysis (A) compares the experimental vs. control group, and within-group analysis (B) compares data at baseline and after study in the experimental group. RESULTS (A) Between-group-analysis: Patients with ZGNZC had a higher endometrium thickness (0.8 ± 0.27 vs. 0.68 ± 0.10; p < .05) and higher type A endometrium rates (34.2% vs. 13.2%; p < .05) than the control group. Pregnancy rates were higher in the experimental than in the control group (43.6% vs. 22.4%; p < .05). (B) Within-group-analysis: ZGNZC increased endometrium thickness (0.58 ± 0.13 vs. 0.87 ± 0.24 vs. 0.83 ± 0.26 vs. 0.80 ± 0.27), and type A endometrium rates (10.9% vs. 60.0% vs. 49.0% vs. 34.2%) (all p < .05). Univariate analysis of pregnancy with other study parameters showed positive and significant correlations between pregnancy and administration of ZGNZC (p < .05). All hepato-renal biomarkers remained within the norm. There were no adverse events. CONCLUSIONS In infertile women with thin endometrium who wish to conceive, two months' application of ZGNZC can improve endometrial properties and proliferation, which is necessary for a healthy pregnancy, and increase the clinical pregnancy rate in our prospective randomized observational study.
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Affiliation(s)
- Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women's Health, University Women's Hospital and Research Centre for Women's Health, University Hospitals of Tuebingen, Tuebingen, Germany
| | - Zhongting Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Xin Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Yu Yang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Suiyu Luo
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Min Min
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Meng Li
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Luping Zhang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Fengyu Jin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Alfred Otto Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
- Department for Women's Health, University Women's Hospital and Research Centre for Women's Health, University Hospitals of Tuebingen, Tuebingen, Germany
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Harpe J, Bernstein C, Harriott A. Migraine and infertility, merging concepts in women's reproductive health: A narrative review. Headache 2022; 62:1247-1255. [PMID: 36200786 DOI: 10.1111/head.14402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective is to examine issues around treating infertility in patients with migraine. BACKGROUND Women outnumber men in migraine diagnosis with a 3:1 ratio; the disease is commonly expressed in women of child-bearing age and is influenced by changes in circulating hormones. Infertility is also common, and the use of treatment options, such as assisted reproductive technology, have expanded exponentially in recent years. METHODS We summarized the literature around the effect of infertility treatments on headache in the general population and migraine population. We also discuss sociobehavioral, economic, and biological factors affecting fertility in patients with migraine, describe infertility protocols, and propose areas of focus for future research. We searched PubMed for the combined key terms in vitro fertilization or assisted reproductive technology AND migraine, or headache. The search included all dates and specified English-language results only. RESULTS Migraine may negatively influence family planning and fertility. Patients face obstacles stemming from the impact of migraine on social relationships and the interference of preventive medications on pregnancy. Migraine may also be associated with an increased prevalence of endocrine disorders which in turn affect fertility. Moreover, infertility treatments are associated with mild headache as a side effect. In addition, we found only one retrospective study demonstrating an increase in headache frequency during in vitro fertilization in the migraine population. CONCLUSIONS We determined that there is little research focused specifically on migraine headache exacerbation and other migraine-associated health outcomes with infertility treatment. This topic merits further interdisciplinary exploration.
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Affiliation(s)
- Jasmin Harpe
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, USA
| | - Carolyn Bernstein
- Department of Neurology, Brigham and Women's Faulkner Hospital, Boston, Massachusetts, USA
| | - Andrea Harriott
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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Magaton I, Helmer A, Roumet M, Stute P, Von Wolff M. Clomiphene citrate stimulated cycles – additional gonadotrophin stimulation increases endometrium thickness without increasing implantation rate. Facts Views Vis Obgyn 2022; 14:77-81. [PMID: 35373551 PMCID: PMC9612865 DOI: 10.52054/fvvo.14.1.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
It is known that Clomiphene citrate (CC) reduces endometrial thickness, but it is unknown if additional gonadotrophin stimulation increases endometrial thickness and if this has an effect on implantation rate in in vitro fertilization (IVF).
The retrospective study included 263 minimal stimulation IVF-cycles stimulated with 25 mg CC per day (CC- IVF), and 161 IVF-cycles stimulated with CC plus 75IU hMG (human Menopausal Gonadotrophin) per day (CC/ hMG-IVF). Endometrial and oestradiol (E2) measurements were analysed between day -4 and 0 (0 = day of oocyte retrieval) and the association of endometrial thickness and treatment on implantation rates were studied after multiple adjustments.
It was shown that on day 0, endometrium was significantly thicker in CC/hMG-IVF versus CC-IVF cycles (9.81 ±2.68 versus 9.06 ±2.54 mm, p = 0.005). However, increased endometrial thickness did not have an effect on implantation and live birth rates.
In conclusion, gonadotrophins should not be added to low dose CC treated IVF cycles just to increase endometrial thickness as increased endometrial thickness does not increase implantation rate.
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Xu Z, Ruan X, Xu X, Yang Y, Cheng J, Luo S, Min M, Li M, Zhang L, Ju R, Jin F, Mueck AO. Efficacy and safety of Zi Gui Nv Zhen ® capsules used in TCM for fertility preservation in patients with diminished ovarian reserve. Gynecol Endocrinol 2022; 38:73-77. [PMID: 34308735 DOI: 10.1080/09513590.2021.1957095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To evaluate for the first time whether Zi Gui Nv Zhen® capsules (ZGNZC), until now used in traditional Chinese medicine (TCM) for menopausal complaints, can increase the fertility of Chinese women with diminished ovarian reserve (DOR). METHODS Prospective, randomized, open-labeled 3-monthly study; 109 DOR patients (aged 20-40 years) receiving either ZGNZC (experimental group, n = 75) or not (control group, n = 34). Main outcomes: markers for ovarian function, thickness/type of the endometrium during ovulation, and pregnancy rate. Between-group analysis (A) comparing experimental vs. control group and within-group analysis (B) comparing data at baseline and after study in each of both groups. RESULTS (A) Between-group-analysis: patients with ZGNZC had a higher endometrium thickness (0.75 vs. 0.62; p<.05) and higher anti-Müllerian hormone (AMH, 0.50 vs. 0.40; p<.05) than control group. Pregnancy rates were higher in the experimental than the control group (26.7% vs. 14.7%; n.s.). (B) Within-group-analysis: ZGNZC decreased levels of follicle-stimulating hormone (FSH, 11.42 vs. 8.69), increased estradiol-levels (E2, 56.09 vs. 73.36), and type A endometrium rates (5.3% vs. 39.7%) (all p< .05) and increased antral follicle count (AFC, 2 vs. 3). All hepato-renal biomarkers remained within the norm. The tolerability was good. There were no adverse events. CONCLUSIONS In women with DOR who wish to conceive, three months' application of ZGNZC can improve ovarian function and oocyte quality by adjusting the neuroendocrine system, can improve endometrial properties and proliferation, necessary for a healthy pregnancy, and increased the clinical pregnancy rate in our prospective randomized observational study.
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Affiliation(s)
- Zhongting Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiangyan Ruan
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
| | - Xin Xu
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yu Yang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jiaojiao Cheng
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Suiyu Luo
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Min Min
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Meng Li
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Luping Zhang
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Rui Ju
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Fengyu Jin
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Alfred Otto Mueck
- Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
- Department of Women's Health, Research Centre for Women's Health and University Women's Hospital of Tuebingen, University of Tuebingen, Tuebingen, Germany
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Yin XD, Xue XO, Wang JS, Yang W, He JQ. Effect of Bushen Huoxue recipe on women with thin endometrial ovulation disorder and a rat model of thin endometrium resulted from kidney deficiency-related blood stasis. Gynecol Endocrinol 2021; 37:433-437. [PMID: 32584196 DOI: 10.1080/09513590.2020.1781079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 02/15/2020] [Accepted: 06/08/2020] [Indexed: 10/24/2022] Open
Abstract
To examine the therapeutic effect of Bushen Huoxue recipe (BHR) on women with thin endometrial ovulation disorder and on a rat model of kidney deficiency-related blood stasis. A total of 60 women with thin endometrial ovulation disorder was enrolled. The primary outcome of the study was the pregnancy rate three menstrual cycles after treatment. The study also examined the changes in the type and thickness of uterine artery, uterine artery pulsatility index (PI) and endometrial resistance index (RI). To establish kidney deficiency-related blood stasis in Sprague Dawley (SD) rats, an intragastric administration of hydroxyurea and a tail vein injection of Dextran were given, following with a flashing of the uterine cavity with 95% anhydrous ethanol. A combined regimen of BHR and estradiol valerate significantly increased the rate of pregnancy in women with thin endometrial ovulation disorder. The treatment was accompanied by a significant increase in endometrial thickness and decreases in uterine artery PI and endometrial RI. In rats, kidney deficiency-related blood stasis caused severe loss in endometrial architecture, thickness, and numbers of gland and blood vessel compared to the healthy SD rats. Treatment with BHR could ameliorate the endometrial damages associated with kidney deficiency-related blood stasis.
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Affiliation(s)
- Xiao-Dan Yin
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Xiao-Ou Xue
- Department of Gynecology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Shang Wang
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Wei Yang
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Jun-Qin He
- Department of TCM, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
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Effect of Ligustrazine on Endometrium Injury of Thin Endometrium Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:7161906. [PMID: 31308854 PMCID: PMC6594312 DOI: 10.1155/2019/7161906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Accepted: 04/30/2019] [Indexed: 01/14/2023]
Abstract
The purpose of this experiment is to establish a rat model of thin endometrium and to explore the effect of ligustrazine on the thin endometrium of rats. The thin endometrium model was made by using infusing absolute ethyl alcohol into the uterine cavity. The thickness of endometrium was measured. Hematoxylin-Eosin (HE) staining was used to observe the histopathological changes of endometrium. The mRNA levels of VEGF, VEGFR-2, PI3K, and AKT were detected by RT-PCR. Western blotting was used to detect the levels of VEGF, VEGFR-2, PI3K, and AKT in endometrial tissue. The thickness of endometrium in the model group was significantly thinner than that in the control group. Compared with the model group, the thickness of endometrium in ligustrazine group was increased. HE staining shown that ligustrazine restored the histopathological changes of endometrium. RT-PCR and Western Blotting results showed that the mRNA and protein levels of VEGF, VEGFR-2, PI3K, and AKT in the model group were significantly decreased compared with the control group, while ligustrazine restored the changes. Ligustrazine can improve the morphology of endometrium, can promote the growth of endometrium, and has obvious therapeutic effect. Its mechanism is related to the activation of PI3K/Akt signaling pathway through upregulation of VEGF and VEGFR-2 expression to induce the repair of thin endometrium in rats.
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Use of Letrozole versus clomiphene-estradiol for treating infertile women with unexplained infertility not responding well to clomiphene alone, comparative study. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2018.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Zhu H, Jiang Y, Pan Y, Shi L, Zhang S. Human menstrual blood-derived stem cells promote the repair of impaired endometrial stromal cells by activating the p38 MAPK and AKT signaling pathways. Reprod Biol 2018; 18:274-281. [PMID: 29941287 DOI: 10.1016/j.repbio.2018.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 06/07/2018] [Accepted: 06/16/2018] [Indexed: 01/21/2023]
Abstract
Multiple studies have confirmed that human menstrual blood-derived stem cells (MenSCs) have potential applications in regenerative medicine or cell therapy. However, the contribution of MenSCs to endometrial repair is currently unknown. We evaluated the protective effects of MenSCs on impaired endometrial stromal cells (ESCs), as well as the signaling pathways involved in this process. Mifepristone was used to damage human ESCs, which were subsequently cocultured with MenSCs. The proliferation, apoptosis, and migration of ESCs were assessed, together with the expression of related signaling proteins including total p38 mitogen-activated protein kinase, P-p38, total protein kinase B (AKT), P-AKT, β-catenin, and vascular endothelial growth factor (VEGF). MenSCs significantly recovered the proliferation and migration ability of impaired ESCs, inhibited ESC apoptosis, and upregulated protein expression of P-AKT, P-p38, VEGF, and β-catenin. Our findings suggest that MenSC-based therapies could be promising strategies for the treatment of endometrial injury, and that AKT and p38 signaling pathways may be involved in this process.
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Affiliation(s)
- Haiyan Zhu
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yinshen Jiang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yibin Pan
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Libing Shi
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Songying Zhang
- Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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Alnemr AAA, Ammar IMM, Aboelfath AMK, Talaat B. Effect of estradiol valerate on the pregnancy rate in patients receiving letrozole for induction of ovulation. MIDDLE EAST FERTILITY SOCIETY JOURNAL 2018. [DOI: 10.1016/j.mefs.2017.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Seyedoshohadaei F, Tangestani L, Zandvakili F, Rashadmanesh N. Comparison of the Effect of Clomiphene- Estradiol Valerate vs Letrozole on Endometrial Thickness, Abortion and Pregnancy Rate in Infertile Women with Polycystic Ovarian Syndrome. J Clin Diagn Res 2016; 10:QC10-3. [PMID: 27656509 DOI: 10.7860/jcdr/2016/20954.8324] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 05/30/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Clomiphene citrate is the first-line therapy for ovulation induction in Polycystic Ovarian Syndrome (PCOS). This drug binds and blocks estrogen receptors and thought to have an anti estrogenic effect on endometrium volume, thus may have adverse effect on fertility. AIM This study aimed to compare the effect of Clomiphene citrate plus Estradiol Valerate with Letrozole on endometrial thickness, abortion and pregnancy rate in infertile women with PCOS undergoing ovulation induction. MATERIALS AND METHODS This was a randomized double blind clinical trial study on 100 women with PCOS, with an endometrial thickness less than 7mm in spite of follicles greater than 18mm after administration of Clomiphene citrate 100mg/d from 3(th) to 7(th) day of menstruation. They were randomly divided in two groups. Group A received 100mg Clomiphene citrate from day 3 to day 7 of menstruation and 4 mg Estradiol Valerate after the 8(th) day of menstruation until 14(th) day. Group B treated by 5mg Letrozole from day 3 to 7 of menstruation with placebo from 8(th) to 14(th) day of menstruation. In both groups endometrial thickness was measured by transvaginal sonography in the 14(th) day of menstruation. Data were analysed using SPSS Ver.18.0. RESULTS The mean age was 30.34 years in group A and 29.62 years in group B (p=0.381). The number of infertility years in group A was 3.73 years and in group B was 3.85 years. There was no significant relationship statistically between the two groups in terms of mean age and infertility years (p=0.99). Endometrial thickness in group A was 7.26mm and in group B was 8.17 mm. Pregnancy rates in group A and group B was 32% and 16% respectively. There was significant relationship statistically between the two groups in terms of endometrial thickness and pregnancy rates (p=0.021 and p=0.05). There was no abortion in group A and 5 cases had abortion in group B, there was a significant relationship between the two groups statistically (p=0.028). CONCLUSION Letrozole increased endometrial thickness and pregnancy rate in infertile women, therefore its administration is recommended.
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Affiliation(s)
- Fariba Seyedoshohadaei
- Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences , Sanandaj, Iran
| | - Laleh Tangestani
- Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences , Sanandaj, Iran
| | - Farnaz Zandvakili
- Assistant Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Kurdistan University of Medical Sciences , Sanandaj, Iran
| | - Naser Rashadmanesh
- Lecturer, Research Center for Gastroenterology and Hepatology, Faculty of Medicine, Kurdistan University of Medical Sciences , Sanandaj, Iran
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Bae SA, Joo JK, Choi JR, Kim SS, Lee KS. Clinical outcomes of three- or five-day treatment with clomiphene citrate combined with gonadotropins and a timed intercourse cycle in polycystic ovary syndrome patients. Clin Exp Reprod Med 2015; 42:106-10. [PMID: 26473110 PMCID: PMC4604293 DOI: 10.5653/cerm.2015.42.3.106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 06/17/2015] [Accepted: 07/06/2015] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study aimed to investigate the effect of a new clomiphene citrate (CC) regimen on preventing thin endometrial lining in polycystic ovary syndrome (PCOS) patients receiving CC plus gonadotropin treatment with a timed intercourse cycle. METHODS A total of 114 women with PCOS were included in this trial. Patients were divided into two groups and treated in accordance with the controlled ovarian stimulation (COS) protocol. In group A, 104 COS cycles in 67 patients were included, and in each cycle 150 mg CC was given for three days, starting from day 3. In group B, 69 COS cycles in 47 patients were included, in which 100 mg CC was given for five days, starting from day 3. The thickness of the endometrium was measured on the day of human chorionic gonadotropin (hCG) injection. Timed intercourse was recommended at 24 and 48 hours after the hCG injection. RESULTS Additional doses of human menopausal gonadotropin and the number of days of hCG administration were not significantly different between the two groups. Endometrial thickness on the day of hCG administration was significantly larger in group A than group B (9.4±2.1 mm vs. 8.5±1.7 mm, p=0.004). The pregnancy rate was significantly higher in group A than in group B (38.4% vs. 21.7%, p=0.030). CONCLUSION Three-day CC treatment resulted in a significantly higher pregnancy rate than the standard five-day CC treatment in a timed intercourse cycle in PCOS patients. Facilitating adequate endometrial growth via the early discontinuation of CC might be a crucial factor in achieving a higher pregnancy rate.
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Affiliation(s)
- Sung-Ah Bae
- Pusan National University Medical Graduate School, Yangsan, Korea
| | - Jong-Kil Joo
- Department of Obstetrics and Gynecology, Medical Research Institute, Pusan National University School of Medicine, Yangsan, Korea
| | | | - Sun-Suk Kim
- Department of Obstetrics and Gynecology, Medical Research Institute, Pusan National University School of Medicine, Yangsan, Korea
| | - Kyu-Sup Lee
- Department of Obstetrics and Gynecology, Medical Research Institute, Pusan National University School of Medicine, Yangsan, Korea
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Peeraer K, Debrock S, De Loecker P, Tomassetti C, Laenen A, Welkenhuysen M, Meeuwis L, Pelckmans S, Mol BW, Spiessens C, De Neubourg D, D'Hooghe TM. Low-dose human menopausal gonadotrophin versus clomiphene citrate in subfertile couples treated with intrauterine insemination: a randomized controlled trial. Hum Reprod 2015; 30:1079-88. [DOI: 10.1093/humrep/dev062] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 02/20/2015] [Indexed: 11/12/2022] Open
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