Evaluating the effects of vitamin E addition to clomiphene citrate on endometrial receptivity: A prospective controlled study
Turkiye Klinikleri Jinekoloji Obstetrik, cilt.20, sa.2, ss.71-76, 2010 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 20 Sayı: 2
- Basım Tarihi: 2010
- Dergi Adı: Turkiye Klinikleri Jinekoloji Obstetrik
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.71-76
- Anahtar Kelimeler: Clomiphene, Endometrium, Infertility, Tocopherols, Ultrasonography, doppler, Vitamin E
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Vitamin E is a non-enzymatic antioxidant that protects the endothelium from oxidative stress. Oxidative stress is an important factor in the pathogenesis of female infertility. We aimed to investigate if vitamin E would improve the negative effects of clomiphene citrate (CC) on endometrium of women having ovulation induction, by using transvaginal color-pulsed Doppler ultrasonography. Material and Methods: In this study, 50 primary infertile normogonadotrophic patients with anovulatory cycles diagnosed by endocrine assays and ovarian transvaginal ultrasonographic scanning for follicle development, were recruited from patients attending to the Clinic of Obstetrics and Gynecology Erzurum Ataturk University. None of the subjects had male infertility or tubal occlusion. In 50 patients, CC (100 mg/day) was prescribed to be taken orally, twice daily for 5 days, starting on the 5th day of the menstrual period (CC group). Since four patients have already become pregnant in the CC group; remaining 46 patients received Vitamin E (300 mg/day) addition to CC, between first and thirteenth days of the following menstrual cycle (CC+vitamin E group). Follicular growth was followed by using transvaginal ultrasonography in all patients. When the mature follicle reached to 16-18 mm in diameter, endometrial thickness was measured. Flow velocity wave forms of spiral artery were recorded for calculation of the mean values pulsatility and resistance indexes (PI and RI) by using transvaginal color-pulsed Doppler ultrasonography. Results: The analysis of results showed that the mean PI and RI values of spiral artery blood flow were higher and endometrial thickness was lower in CC group (n= 50) when compared with CC + vitamin E group (n= 46) (p< 0.01, p< 0.05 and p< 0.01, respectively). The pregnancy rate in CC group (n= 4, 8%) was lower than in CC + vitamin E group (n= 13, 28%) (p< 0.01). Conclusion: The assessment of endometrial blood flow by transvaginal color-pulsed Doppler ultrasonography can be performed to detect endometrial receptivity in women using CC for the induction of ovulation. Spiral artery blood flow parameters may be helpful to demonstrate endometrial perfusion differences during the therapy. The addition of vitamin E to CC may have an improving effect on endometrial blood flow and pregnancy rate. Copyright © 2010 by Türkiye Klinikleri.