Successful pregnancies after combined pentoxifylline-tocopherol treatment in women with premature ovarian failure who are resistant to hormone replacement therapy.
OBJECTIVE
To determine whether treatment with combined pentoxifylline (PTX) and tocopherol (Vit.E) can improve uterine parameters in hormonal replacement therapy (HRT)-resistant women with premature ovarian failure (POF), for whom the outcome of assisted reproductive technology is usually negative. We previously reported that uterine radiation-induced fibrosis is reversible by combined PTX-Vit.E treatment.


METHODS
Case report.


METHODS
Volunteer participants in an oocyte donation (OD) program in a French public hospital.


METHODS
Three women with POF (ages 36 +/- 2 years) using HRT exhibited uterine hormonoresistance, although they had high E(2) plasma levels. Their mean endometrial thickness was 4.9 mm, and they had an echogenic endometrium and thin uterine crosses.


METHODS
Between May 1998 and April 1999, treatment consisted of 800 mg of PTX combined with 1,000 IU of Vit.E daily for at least 9 months.


METHODS
Endometrial thickness, echogenicity, and pulsatility index of the uterine arteries, assessed by ultrasound and Doppler before and after treatment, and embryo implantation by IVF-OD.


RESULTS
PTX-Vit.E treatment was well tolerated and induced improvements, as mean edematous endometrial thickness increased to 7.4 mm, with nice uterine crosses. Three frozen-thawed ETs resulted in two viable pregnancies.


CONCLUSIONS
In women with POF and uterine resistance to HRT, combined PTX-Vit.E reduces fibroatrophic uterine lesions and improves the uterine response to HRT, thus allowing embryo implantation and ongoing pregnancy.
Letur-Konirsch
Hélène
H
Fertility Center, Department of Obstetrics and Assisted Reproductive Techniques, Institut Mutualiste Montsouris, Paris, France. helene.letur@imm.fr
Delanian
Sylvie
S
D000328:Adult; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000097:blood; D015914:Estrogen Replacement Therapy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010431:Pentoxifylline / Q000627:therapeutic use*; D016649:Primary Ovarian Insufficiency / Q000188:drug therapy* / Q000473:pathology; D024505:Tocopherols / Q000627:therapeutic use*
D004958:Estradiol; D024505:Tocopherols; D010431:Pentoxifylline