scholarly journals Role of endometrial thickness in natural and stimulated cycles in infertility

2020 ◽  
Vol 9 (7) ◽  
pp. 2872
Author(s):  
Vandana Dhama ◽  
Kiran Kumari ◽  
Rachna Chaudhary ◽  
Shakun Singh
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Uttar Pradesh ◽  
Sildenafil Citrate ◽  
Estradiol Valerate ◽  
Thin Endometrium ◽  
Infertile Women ◽  
Medical College

Background: The endometrium plays an important role in infertility. The growth of endometrium depends on serum oestradiol level and blood flow to the uterus. A thin endometrium is defined as a lining of less than 7 mm which is associated with infertility. The endometrium is best seen on Transvaginal scan (TVS). The purpose of this study was to evaluate the role of endometrial thickness and its outcome in natural and stimulated cycles in infertile women.Methods: This prospective cohort study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut, Uttar Pradesh, India. Total 150 infertile women of age less than 35 years presented with either primary or secondary infertility were enrolled. Each patient was undergoing transvaginal scan (TVS) to measure endometrial thickness follicular monitoring.Results: The endometrial thickness and pregnancy rate was higher in letrozole induced group as compared to clomiphene with estradiol valerate and clomiphene with sildenafil citrate induced group.Conclusions: Letrozole had better effect on endometrial thickness and pregnancy rate as compared to clomiphene citrate with estradiol valerate and clomiphene citrate with sildenafil citrate.

scholarly journals COMPARISON OF EFFECT OF CLOMIPHENE CITRATE WITH ESTRADIOL VALERATE V/S LETROZOLE ON PREGNANCY RATE IN INFERTILE WOMEN WITH PCOS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Mendiratta Suman ◽  
Joshi Amit Kumar ◽  
Netra Harendra Kumar
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Pregnancy Rate ◽  
Polycystic Ovary ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Estradiol Valerate ◽  
Ovary Syndrome ◽  
Infertile Women ◽  
Group A ◽  
Group B

Background: Polycystic ovary syndrome is the commonest endocrinopathy in anovulatory infertility in young women. It is estimated that infertility affects 10 to 14% of the Indian population of which approximately 25-30% part occupied by PCOS. Methods: This prospective study enrolled 180 infertile women with PCOS, age 21-35 yrs who have taken 1 cycle of clomiphene citrate 100 mg, endometrial thickness <7 mm inspite of follicles greater than 18 mm. Half of them treated with clomiphene citrate with estradiol valerate and remaining half with letrozole. Results: In Group-A treated with clomiphene citrate with estradiol valerate 13 patients (16.3%) conceived and in Group-B treated with letrozole 26 patients (32.5%) conceived. Conclusion: Pregnancy rate is higher in group which treatment with letrozole in comparison with clomiphene citrate plus estradiol valerate. Keywords: Polycystic ovary syndrome, Infertility, Pregnancy rate

scholarly journals Effect of sildenafil citrate on treatment of infertility in women with a thin endometrium: a systematic review and meta-analysis

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096958
Author(s):  
Xin Li ◽  
Ting Luan ◽  
Chun Zhao ◽  
Mianqiu Zhang ◽  
Li Dong ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Sildenafil Citrate ◽  
Control Group ◽  
Weighted Mean ◽  
Thin Endometrium ◽  
Infertile Women ◽  
Biochemical Pregnancy

Objective Endometrial thickness is a prognostic factor for successful pregnancy. This meta-analysis aimed to examine the role of sildenafil citrate on infertile women with a thin endometrium. Methods Two investigators independently searched the literature on sildenafil citrate and infertile women with a thin endometrium from PubMed, EMBASE, and the Cochrane Controlled Trials Register Database from inception to January 2019. Results Nine studies involving 1452 patients were included for analysis in our study. We found that endometrial thickness in patients who received sildenafil citrate was significantly higher than that in the control group (placebo or no treatment) (weighted mean difference: 1.22; 95% confidence interval [CI]: 1.07–1.38). The radial artery resistance index was significantly lower (weighted mean difference: −0.12; 95% CI: −0.17 to −0.06), and the clinical pregnancy rate (risk ratio: 1.31; 95% CI: 1.11–1.53) and biochemical pregnancy rate (risk ratio: 1.45; 95% CI: 1.11–1.89) were significantly higher in the sildenafil citrate group compared with the control group. Conclusion Sildenafil citrate is effective in improving endometrial thickness, the clinical pregnancy rate, and the biochemical pregnancy rate in women who have a thin endometrium. This treatment is a potential therapeutic intervention for a thin endometrium.

TO COMPARE THE COMBINED EFFECT OF ORAL SILDENAFIL AND ESTRADIOL VALERATE TO ESTRADIOL VALERATE ALONE IN PATIENTS WITH CLOMIPHENE INDUCED CYCLES IN INFERTILE WOMEN ON ENDOMETRIAL THICKNESS.

2021 ◽  
pp. 13-16
Author(s):  
Rekha Rani ◽  
Shikha Singh ◽  
Sangita Sahu ◽  
Ruchika Garg ◽  
Urvashi Urvashi ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Randomized Study ◽  
Concomitant Administration ◽  
Combined Effect ◽  
Estradiol Valerate ◽  
Control Group ◽  
Negative Effects ◽  
Infertile Women ◽  
Medical College

Objective- Endometrial thickness <7 mm accepted as a reliable sign of suboptimal implantation potential. Clomiphene citrate (CC) has some negative effects on the endometrium. We evaluated the effect of concomitant administration of oral sildenal and estradiol valerate on endometrial thickness Aim- To compare the combined effect of oral sildenal and estradiol valerate to estradiol valerate alone in patients with clomiphene induced cycles in infertile women on endometrial thickness. Material And Method- This randomized study was conducted on infertile women attending infertility OPD in SN Medical College, Agra over a period of 2 years from January 2019 to December 2020. Infertile patients were randomly divided into two equal groups. In control group, 50 patients were given clomiphene citrate 50 mg daily from D2 to D6 along with estradiol valerate 2 mg thrice daily from 2nd day of the cycle till the day of trigger of ovulation. In study group, 50 patients were given clomiphene citrate 50 mg daily from D2 to D6 along with estradiol valerate 2mg 12 thrice daily plus oral sildenal citrate 25mg every 8 h from 2nd day of the cycle till the day of hCG trigger. Results- The results in this study conrm the superiority of using oral sildenal with estradiol for improving endometrial thickness, vascularity and pregnancy rates. Conclusion- Addition of oral sildenal citrate to estradiol valerate in ovulation induction cycles has better results in improving endometrial thickness, endometrial blood ow and pregnancy outcome as compared to estradiol valerate alone in women with anovulatory infertility

scholarly journals Efficacy and Side Effects of Letrozole Over Clomiphene citrate for Ovulation Induction of the Patients with PCOS: A Randomized Controlled Trial

2021 ◽  
Vol 15 (2) ◽  
pp. 69-73
Author(s):  
Poly Begum ◽  
Dipti Rani Shaha ◽  
Md Kamrul Hassan ◽  
Dilruba Zeba
Keyword(s):  
Side Effects ◽  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Clomiphene Citrate ◽  
Multiple Pregnancy ◽  
Ovulation Rate ◽  
Medical College ◽  
Drug Of Choice ◽  
Group B

Clomiphene citrate (CC) has been the drug of choice for the treatment of anovulatory subfertility in women with polycystic ovarian syndrome (PCOS) for a long time. Despite high ovulation rate of CC, its pregnancy rate is low. Letrozole, an aromatase inhibitor has been considered as an alternative of CC but its effectiveness is yet controversial. Our aim was to compare the efficacy and side effects of Letrozole over CC. This randomized control clinical trial was conducted in Diabetic Association Medical College and Hospital, Faridpur, Bangladesh from January 2018 to December 2019. A total of 160 women diagnosed as PCOS by Rotterdam criteria seeking treatment of subfertility were included in the study. Participants were randomly divided into two groups. Group A got Letrozole and Group B got CC as treatment. Transvaginal ultrasonogram (TVS) was performed on 12 to 13th day of the cycle to see the details of the follicles and the endometrium. The demographic information of the participants and the side effects of the drugs were recorded. Successful pregnancies were followed up for 12 weeks. Ovulation rate was almost similar among the participants of both of the groups. But monofo licular development and pregnancy rate were significantly higher among the Letrozole group (p = 0.004 and p = 0.008 respectively). Multifo licular development, multiple pregnancy, and abortion rate were significantly higher in the CC group. Patients who took Letrozole had significantly higher endometrial thickness than CC group. Both of the groups reported relatively similar incidence of side effects. Due to the higher pregnancy rate and lower incidence of abortion or multiple pregnancy, Letrozole can be an effective alternative to CC for the treatment of anovulatory subfertility of the PCOS patients. Faridpur Med. Coll. J. 2020;15(2): 69-73

scholarly journals Role of intrauterine tubo-peritoneal insemination and intrauterine insemination in the treatment of infertility

2017 ◽  
Vol 5 (5) ◽  
pp. 2057
Author(s):  
Disha Gupta ◽  
Asha Verma ◽  
Richa Gupta ◽  
Soniya Saini ◽  
Anuradha Salvi ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Intrauterine Insemination ◽  
Clomiphene Citrate ◽  
Positive Outcome ◽  
Exclusion Criteria ◽  
Significant Difference ◽  
Infertile Patients ◽  
Urine Pregnancy Test

Background: Infertility management has become more substantial and relevant with an increase in the number of infertile patients as well as advances in the science of reproduction. The objective of our study was to assess the role of intrauterine tuboperitoneal insemination (IUTPI) and intrauterine insemination (IUI) in the treatment of infertile patients.Methods: 236 infertile patients, 118 in each group attending the infertility clinic, after applying both inclusion and exclusion criteria were enrolled in the present study. Patients in each study group were given clomiphene citrate for ovarian stimulation followed by injection hCG for triggering ovulation. Insemination with washed husband’s sperm was performed about 36-40 hours after hCG administration, using 10ml of  inseminate in IUTPI and 0.5ml inseminate in IUI. The patient was then called after 2 weeks for urine pregnancy test (UPT) which, if positive was considered as clinical pregnancy.Results: Out of the total 236 cases, 42 cases had a positive outcome. Out of these 42 positive cases, 27 were from IUTPI group whereas 15 from IUI group. The pregnancy rate was 22.88% in IUTPI and 12.71% in IUI (p=0.039), which was a statistically significant difference. Endometrial thickness, preovulatory follicle number and prewash sperm motility significantly affected positive outcome in IUTPI. Factors like patient’s age, BMI<25, bilateral patent tubes and decreased duration of infertility also positively affected the treatment outcome.Conclusions: Our study found IUTPI to have better pregnancy rate compared to IUI. IUTPI may become a first line option for treatment of infertile patients.

scholarly journals Clomiphene citrate versus letrozole for ovulation induction in anovulatory infertility: a prospective study

2020 ◽  
Vol 9 (5) ◽  
pp. 2004
Author(s):  
Monica Soni ◽  
Gajendra Kumar Kalal ◽  
Arti Meena ◽  
Anita Sharma
Keyword(s):  
Pregnancy Rate ◽  
Ovulation Induction ◽  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Obstetrics And Gynecology ◽  
Exclusion Criteria ◽  
Medical College ◽  
A Prospective Study ◽  
Written Informed Consent ◽  
Anovulatory Infertility

Background: The objective of this study was to compare clomiphene citrate with letrozole for ovulation induction in anovulatory infertile women.Methods: This study was conducted in the infertility clinic and department of obstetrics and gynecology, S.P. Medical College and Associated P. B. M. Hospital, Bikaner, Rajasthan, from 1st August 2018 to 31st July 2019. The study group comprised of infertile females attending infertility clinic or gynae outdoor in department of obstetrics and gynecology, S. P. Medical College Bikaner for infertility. 100 women with anovulatory infertility were enrolled in the study after fulfilling the inclusion and exclusion criteria. Proper counseling was done and written informed consent taken.Results: Ovulation rate was statistically significantly greater in letrozole group. Monofollicular development was statistically significant greater in let group (CC 18%, Let 66%). The endometrial thickness on the day of ßhCG administration in CC group was 7.40±1.08 mm and in let group was 8.20±0.82 mm. Letrozole treated cases had better trilaminar pattern of endometrium as compared to clomiphene. The pregnancy rate was higher in letrozole group.Conclusions: As compare to clomiphene, letrozole is associated with higher pregnancy rate and ovulation rates among infertile women with anovulation.

scholarly journals The Effect of Estradiol Valerate with and without Oral Sildenafil on Endometrial Thickness and Pregnancy Rates in Infertile Women: A R.C.T

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M A M F Kortam ◽  
H F Mohammad ◽  
M H Mobarak ◽  
A A I Bazazo
Keyword(s):  
Endometrial Thickness ◽  
Clomiphene Citrate ◽  
Resistive Index ◽  
Estradiol Valerate ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Induction Of Ovulation ◽  
Infertile Women ◽  
Hcg Trigger

Abstract Objectives To evaluate the effect of sildenafil-estrogen combination compared to estrogen alone on endometrium thickness in infertile women received induction of ovulation by clomiphene citrate. Study design Randomized controlled clinical trial. Settings University hospital, Ain Shams University Maternity Hospital. Materials and methods 90 infertile women with unexplained infertility, were recruited and randomly allocated into two equal groups, 45 patients in each. Both groups received induction of ovulation with CC 100mg/d from 2nd to 6th day of cycle and oral estradiol valerate 2mg 12 hourly from 2nd day of the cycle till the day of trigger of ovulation. In study group oral sildenafil citrate 25mg every 8 h from 2nd day of the cycle till the day of HCG trigger was added. Endometrium was evaluated as regards both endometrial thickness and pattern, uterine artery resistive index (RI) was measured at the day of trigger. Qualitative serum B-hCG level was checked 14 days after ovulation to assess chemical pregnancy rate. Results Mean endometrial thickness at the time of hCG trigger was 9.8 mm in study group and 8.42 mm in control group (P value &lt;0.001). 88.9% patients given sildenafil had trilaminar endometrium whereas 29% patients without sildenafil had bilaminar endometrial pattern (P value = 0.006). Mean uterine artery resistive index (RI) after adding sildenafil was non-significantly lower among study group than among control group, the value were 0.66 and 0.72 respectively (P = 0.078). Pregnancy rates in study group and control group was 17.8% and 11.1% respectively. Conclusion Sildenafil-estrogen combination has a potent effect on improving the endometrium (thickness and pattern) in patients undergoing induction of ovulation by clomiphene citrate. This improvement in endometrial development has a weak positive feedback on pregnancy rate.

scholarly journals Effectiveness of electroacupuncture for thin endometrium in infertile women: study protocol for a single-blind, randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fangyuan Li ◽  
Hua Lu ◽  
Xinxin Wang ◽  
Qi Zhang ◽  
Qianchen Liu ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Pregnancy Rate ◽  
Endometrial Thickness ◽  
Controlled Trial ◽  
Resistance Index ◽  
Endometrial Receptivity ◽  
Controlled Clinical Trial ◽  
Thin Endometrium ◽  
Infertile Women ◽  
Randomized Controlled

Abstract Background Thin endometrium negatively impacts the reproductive function. Current treatments for thin endometrium do not always improve endometrial receptivity. Preliminary evidence suggests that electroacupuncture could have potential therapy for thin endometrium in infertile women. Thus, this randomized controlled trial was designed to test whether electroacupuncture can improve endometrial receptivity in infertile women with thin endometrium. Methods This study is a randomized, single-blinded, controlled, clinical trial. A total of 142 eligible patients will be recruited and randomly assigned to the electroacupuncture (EA) group or the sham electroacupuncture (SEA) group in a 1:1 ratio. Participants will receive 36 sessions over three menstrual cycles (12 weeks in total), with the same acupoint prescription. The primary outcome of this trial is endometrial thickness in the midluteal phase. The secondary outcomes include endometrial pattern, resistance index (RI) and pulsatility index (PI) of bilateral uterine artery and endometrium blood flow, serum estradiol (E2) and progesterone (P), and pregnancy rate. The pregnancy rate will be evaluated during a 6-month follow-up after completion of the trial. All other outcomes will be evaluated before treatment, during the treatment of 1st, 2nd, and 3rd menstrual cycle, and 6 months after treatment. Discussion If the outcome confirms the effectiveness of electroacupuncture for thin endometrium in infertile women, this treatment will be proposed for application in clinical practice. Trial registration Chinese Clinical Trials Registry ChiCTR2000029983. Registered on 18 February 2020

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