The effect of administering vaginal estrogen to clomiphene citrate stimulated cycles on endometrial thickness and pregnancy rates in unexplained infertility

Abstract

Objective: Clomiphene citrate (CC) has some negative effects on the endometrium. We aimed to determine the effect of vaginally administered local estrogen (LE) on endometrial thickness (ET) and pregnancy rates in CC stimulated cycles. Material and Methods:This was a prospective randomized crossover study that took place in a university hospital. The patients had received CC due to unexplained infertility (UI). Two different treatment protocols were given sequentially as, either CC+LE or CC alone. Each protocol was planned for two cycles and there was a one-month wash-out period between protocols. The effects of LE on the 3 rd and 9 th day, the ovulation day (OD) and 7 th postovulation day (POD7) were investigatedResults: A total of 6 pregnancies were achieved with 3 patients from each protocol. The ET was 7.6±1.4 mm and 8.3±2.1 mm respectively and significantly different in the CC group and the CC+E2 groups on the OD (p=.039), while these values were 9.7±2.3 mm and 10.9±3.0 mm respectively and significantly different on the POD7 (p=.007). There was no significant difference between the groups for arterial PI values on the OD and POD7. The frequency of thin endometrium (<6 mm) was 15.2% and 12.2% respectively in the CC group and the CC+E2 group on the OD (p=.628) and 5.1% and 1.2% respectively on the POD7 (p=.182). Conclusion:Adding vaginal LE to CC stimulated cycles led to a significant increase in ET on the OD and POD7. However, this difference in thickness was not reflected in the pregnancy rates in this study.

The synergistic effect of electroacupuncture and bone mesenchymal stem cell transplantation on repairing thin endometrial injury in rats

“…Regeneration of the endometrium is a major issue in gynecology and reproductive medicine. To increase the endometrial thickness, various strategies have been adopted, such as systemic or vaginal estrogen [36, 37], low-dose aspirin supplements [38], and intravaginal sildenafil [39], all with limited success. Other methods, such as the use of aromatase inhibitors [40] and delaying the administration of human chorionic gonadotropin [41], have also been suggested.…”

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

“…Dose schedule is different from fresh cycle. 14 Jimenez PT et al used oral estradiol 2 mg thrice daily from day one for 12 days. They reported appropriate development of endometrium in 67% patients.…”

A Comparison Between the Effect of Vaginal Sildenafil Versus Oral Estradiol Valerate on Ultrasound Parameters of Endometrial Receptivity and Follicular Growth in Iraqi Females Receiving Letrozole for Induction of Ovulation

“…Patients treated with sildenafil citrate demonstrate a significant rise in endometrial thickness and a higher pregnancy outcome compare with the control group receiving no treatment (El-Shourbagy, et al [19] ). [20] ). The results of a meta- for thin endometrium improves endometrial thickness compared to patients using placebo only (Torres, et al [21] ).…”