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

To study and compare the effect of vaginal sildenafil and estradiol valerate on endometrial thickness, blood flow and pregnancy rates in infertile women undergoing intrauterine insemination

“…In a prospective study by Takasaki et al of 61 patients with a thin endometrium (8 mm), there was a significant improvement in endometrial thickness in 11 patients. 12 In a meta-analysis done by Torres RF et al use of pure ethinyl estradiol for treatment of thin endometrium was examined, the observations made were: addition of ethinyl estradiol (EE) does improve the endometrial thickness in comparison to patients where only placebo was used. 13 Cetinkaya K et al used vaginally administered local oestrogen 25 mcgms from 4 th day for 15 days in clomiphene citrate induced cycle.…”

“…15 Takasaki et al used 100 mg sildenafil intravaginal starting first day of cycle till day of ovulation and 92% patients showed improvement in endometrial thickness. 12 Firouzabadi et al used 50 mg orally Sildenafil starting 1st day till 45-72 hours prior to embryo transfer. Endometrial thickness and triple line pattern was found significantly higher with sildenafil and estadiol valerate as compared to estradiol alone.…”

Thin endometrium transcriptome analysis reveals a potential mechanism of implantation failure

“…The level of blood flow impedance in the uterine radial artery was measured as a resistance index with a pulsed Doppler. The cut‐off value of the endometrial thickness and level of blood flow impedance were defined as <8 mm and ≥0.81 mm, respectively, based on the authors' previous studies 4, 7, 8. Three patients had a normal‐thickness endometrium (endometrial thickness ≥8 mm) and three patients had a thin endometrium (Thin; endometrial thickness <8 mm) (Table 1).…”

“…Women with thin endometria have lower pregnancy rates, largely related to implantation failure 1, 2, 3, 4, 5, 6. The authors recently found high blood impedance in the uterine radial artery in patients with a thin endometrium4 and that vitamin E, L‐arginine, and sildenafil citrate treatments, which increase the blood flow of the uterine radial artery, helped to thicken the endometrium 7. This suggests that a low level of blood flow to the endometrium reduces its thickness, although it remains unclear why this would result in implantation failure.…”

Does Thin Endometrium in Infertile Women Indicate Genital Tuberculosis?

“…Endometrium was considered to be thin if it was >8mm as per the studies by Miwa I, et al 13 and Takasaki et al 14 Endometrial thickness was >8mm in 52 women (86.66%), while it was ≥8mm in 8 (13.33%). The incidence of thin endometrium in natural cycles has been reported to be 5% in women <40 years of age.…”