Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium.
OBJECTIVE
To examine whether thin endometria can be improved by increasing uterine radial artery (uRA) blood flow.


METHODS
A prospective observational study.


METHODS
University hospital and city general hospital.


METHODS
Sixty-one patients with a thin endometrium (endometrial thickness [EM] <8 mm) and high radial artery-resistance index of uRA (RA-RI >or=0.81).


METHODS
Vitamin E (600 mg/day, n = 25), l-arginine (6 g/day, n = 9), or sildenafil citrate (100 mg/day, intravaginally, n = 12) was given.


METHODS
EM and RA-RI were assessed by transvaginal color-pulsed Doppler ultrasound.


RESULTS
Vitamin E improved RA-RI in 18 (72%) out of 25 patients and EM in 13 (52%) out of 25 patients. L-arginine improved RA-RI in eight (89%) out of nine patients and EM in six (67%) patients. Sildenafil citrate improved RA-RI and EM in 11 (92%) out of 12 patients. In the control group (n = 10), who received no medication to increase uRA-blood flow, only one (10%) patient improved in RA-RI and EM. The effect of vitamin E was histologically examined in the endometrium (n = 5). Vitamin E improved the glandular epithelial growth, development of blood vessels, and vascular endothelial growth factor protein expression in the endometrium.


CONCLUSIONS
Vitamin E, l-arginine, or sildenafil citrate treatment improves RA-RI and EM and may be useful for the patients with a thin endometrium.
Takasaki
Akihisa
A
Department of Obstetrics and Gynecology, Saiseikai Shimonoseki General Hospital, Kifunecho, Shimonoseki, Japan.
Tamura
Hiroshi
H
Miwa
Ichiro
I
Taketani
Toshiaki
T
Shimamura
Katsunori
K
Sugino
Norihiro
N
D000282:Administration, Intravaginal; D000284:Administration, Oral; D000328:Adult; D001120:Arginine / Q000008:administration & dosage*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects / Q000254:growth & development* / Q000473:pathology; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D009929:Organ Size / Q000187:drug effects; D010865:Pilot Projects; D010879:Piperazines / Q000008:administration & dosage*; D011687:Purines / Q000008:administration & dosage; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology*; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage*; D014463:Ultrasonography; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000187:drug effects / Q000502:physiology; D014591:Uterine Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D014599:Uterus / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D014665:Vasodilator Agents / Q000008:administration & dosage; D014810:Vitamin E / Q000008:administration & dosage*; D055815:Young Adult
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D014810:Vitamin E; D001120:Arginine; D000068677:Sildenafil Citrate