sildenafil-citrate and Uterine-Diseases

To examine whether thin endometria can be improved by increasing uterine radial artery (uRA) blood flow.. A prospective observational study.. University hospital and city general hospital.. Sixty-one patients with a thin endometrium (endometrial thickness [EM] <8 mm) and high radial artery-resistance index of uRA (RA-RI >or=0.81).. Vitamin E (600 mg/day, n = 25), l-arginine (6 g/day, n = 9), or sildenafil citrate (100 mg/day, intravaginally, n = 12) was given.. EM and RA-RI were assessed by transvaginal color-pulsed Doppler ultrasound.. Vitamin E improved RA-RI in 18 (72%) out of 25 patients and EM in 13 (52%) out of 25 patients. L-arginine improved RA-RI in eight (89%) out of nine patients and EM in six (67%) patients. Sildenafil citrate improved RA-RI and EM in 11 (92%) out of 12 patients. In the control group (n = 10), who received no medication to increase uRA-blood flow, only one (10%) patient improved in RA-RI and EM. The effect of vitamin E was histologically examined in the endometrium (n = 5). Vitamin E improved the glandular epithelial growth, development of blood vessels, and vascular endothelial growth factor protein expression in the endometrium.. Vitamin E, l-arginine, or sildenafil citrate treatment improves RA-RI and EM and may be useful for the patients with a thin endometrium.

Topics: Administration, Intravaginal; Administration, Oral; Adult; Arginine; Endometrium; Female; Humans; Infertility, Female; Organ Size; Pilot Projects; Piperazines; Purines; Regional Blood Flow; Sildenafil Citrate; Sulfones; Ultrasonography; Uterine Artery; Uterine Diseases; Uterus; Vasodilator Agents; Vitamin E; Young Adult

We report the use of hyperbaric oxygen therapy (HBO2) in the treatment of an unusual case of secondary infertility. The patient had failed to conceive after a 1-year period of in-vitro fertilization, during which oral sildenafil had also been administered. However she became pregnant after an IVF cycle and the use of adjunctive HBO2 and sildenafil, which was administered intravaginally on this occasion. There is currently very little evidence to support the use of HBO2 in this context. The possible mechanisms of action of HBO2 in this case are discussed.

Topics: Adult; Cicatrix; Combined Modality Therapy; Endometrium; Female; Fertilization in Vitro; Humans; Hyperbaric Oxygenation; Infertility, Female; Piperazines; Postpartum Hemorrhage; Pregnancy; Purines; Sildenafil Citrate; Sulfones; Uterine Diseases; Vasodilator Agents