Successful use of vaginal sildenafil citrate in two infertility patients with Asherman's syndrome.
Vaginal sildenafil citrate (Viagra, Pfizer, Inc., New York, NY) has been shown to be useful in increasing endometrial thickness and achieving pregnancy in women with varied uterine disorders. However, it failed to demonstrate favorable results in the setting of Asherman's syndrome, a condition characterized by the presence of uterine synechiae. We have successfully applied this treatment in two women noted to have inadequate endometrium after surgical resection of uterine synechiae. Both patients had a history of a postpartum uterine curettage with subsequent secondary infertility. Asherman's syndrome was surgically demonstrated and treated in both patients. Postoperatively, both patients were noted to have a thin endometrium and failed to conceive despite fertility treatment. Subsequently, these women achieved pregnancy in the first treatment cycle with vaginal sildenafil citrate. Using transvaginal ultrasound, endometrial thickness was noted to improve when sildenafil citrate was administered. It is suspected that this medication causes selective vasodilatation, resulting in improved endometrial development.
Zinger
Michael
M
Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, Cincinnati, Ohio 45267, USA.
Liu
James H
JH
Thomas
Michael A
MA
D000282:Administration, Intravaginal; D000328:Adult; D004717:Endometrium / Q000098:blood supply* / Q000187:drug effects; D005260:Female; D006175:Gynatresia / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy* / Q000209:etiology; D010879:Piperazines / Q000008:administration & dosage*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*; D016387:Women's Health
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate