Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium

Fertil Steril. 2010 Apr;93(6):1851-8. doi: 10.1016/j.fertnstert.2008.12.062. Epub 2009 Feb 6.

Abstract

Objective: To examine whether thin endometria can be improved by increasing uterine radial artery (uRA) blood flow.

Design: A prospective observational study.

Setting: University hospital and city general hospital.

Patient(s): 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).

Intervention(s): 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.

Main outcome measure(s): EM and RA-RI were assessed by transvaginal color-pulsed Doppler ultrasound.

Result(s): 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.

Conclusion(s): Vitamin E, l-arginine, or sildenafil citrate treatment improves RA-RI and EM and may be useful for the patients with a thin endometrium.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravaginal
  • Administration, Oral
  • Adult
  • Arginine / administration & dosage*
  • Endometrium / diagnostic imaging
  • Endometrium / drug effects
  • Endometrium / growth & development*
  • Endometrium / pathology
  • Female
  • Humans
  • Infertility, Female / drug therapy
  • Infertility, Female / etiology
  • Infertility, Female / pathology
  • Organ Size / drug effects
  • Pilot Projects
  • Piperazines / administration & dosage*
  • Purines / administration & dosage
  • Regional Blood Flow / drug effects
  • Regional Blood Flow / physiology*
  • Sildenafil Citrate
  • Sulfones / administration & dosage*
  • Ultrasonography
  • Uterine Artery / diagnostic imaging
  • Uterine Artery / drug effects
  • Uterine Artery / physiology
  • Uterine Diseases / complications
  • Uterine Diseases / drug therapy*
  • Uterine Diseases / pathology
  • Uterus / blood supply*
  • Uterus / diagnostic imaging
  • Uterus / pathology
  • Vasodilator Agents / administration & dosage
  • Vitamin E / administration & dosage*
  • Young Adult

Substances

  • Piperazines
  • Purines
  • Sulfones
  • Vasodilator Agents
  • Vitamin E
  • Arginine
  • Sildenafil Citrate