Adjuvant therapy enhances endometrial receptivity in patients undergoing assisted reproduction.
Adjuvant therapies are often used to enhance endometrial thickness during IVF. This retrospective cohort analysis investigated if women undergoing oocyte donation cycles with sonographic evidence of endometrial insufficiency benefit from adjuvant medicaltherapy. Infertile patients received 503 mock cycles followed by 503 anonymous oocyte donation cycles. One hundred and twenty-three patients received adjuvant therapy during a donor oocyte cycle. Patients who had a mock endometrial thickness > or = 8 mm experienced a significant decrease in endometrial thickness with the donor oocyte cycle regardless of the use of adjuvant therapy (P < 0.001). In contrast, those patients with a mock endometrial thickness < 8 mm experienced a significant increase in donor oocyte cycle endometrial thickness regardless of adjuvant therapy use (P < 0.001). The patients with a mock endometrial thickness < 8 mm experienced a significant improvement in pregnancy rates when taking adjuvant therapy (87.7 versus 73.5%, P < 0.05). Adjuvant therapy significantly improved both pregnancy (87.8 versus 76.8%, P < 0.01) and live birth rates (74.8 versus 63.7%, P < 0.05) in the entire patient population. While the use of adjuvant therapy did not significantly improve ultrasonographic endometrial thickness, it did improve outcome rates.
Frattarelli
John L
JL
Tripler Army Medical Centre, Department of Obstetrics and Gynecology, 1 Jarrett White Road, Honolulu, HI 96859-5000, USA. jfrattarelli@rmanj.com
Miller
Bradley T
BT
Scott
Richard T
RT
D000328:Adult; D001241:Aspirin / Q000494:pharmacology; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects*; D004958:Estradiol / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D018587:Oocyte Donation / Q000379:methods*; D010879:Piperazines / Q000494:pharmacology; D011247:Pregnancy; D011687:Purines; D012189:Retrospective Studies; D000068677:Sildenafil Citrate; D013450:Sulfones; D016896:Treatment Outcome; D014463:Ultrasonography; D014665:Vasodilator Agents / Q000494:pharmacology
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D004958:Estradiol; D000068677:Sildenafil Citrate; D001241:Aspirin