Service de Médecine de la Reproduction, Hôpital Jean Verdier APHP, Bondy, France.
Service de Médecine de la Reproduction, Hôpital Paul de Viguier, Toulouse, France.
Hum Fertil (Camb). 2021 Dec;24(5):367-375. doi: 10.1080/14647273.2019.1673906. Epub 2019 Oct 10.
Poor endometrial development during fertilization remains challenging. Indeed, no broadly accepted definition of poor endometrial development exists, and no treatment has shown any improvement in the condition. The aim of this study was to analyze whether treatment with a combination of pentoxifylline and tocopherol increases endometrial volume. This monocentric and retrospective study includes patients with previous miscarriages, fertilization failure, or poor endometrial development. The patients had an ultrasonography during the mid-luteal phase to assess both endometrial thickness and endometrial volume (EV). If the volume was less than 2 mL, they were given pentoxifylline (PTX) and tocopherol for at least 2 months before a second ultrasound assessment. One hundred and forty-four patients were analyzed. The mean duration of treatment was 132 days. The combination of tocopherol and PTX significantly increased the EV by 0.47 mL ( < 0.0001; 95% CI 0.38-0.57). The mean ± SD EV was 1.34 ± 0.38 mL and 1.82 ± 0.63 mL before and after the treatment respectively. No data concerning pregnancy rates were interpretable. We showed an improvement of poor endometrial proliferation with a treatment including PTX and tocopherol. These promising results should be followed up by a prospective study.
胚胎受精时子宫内膜发育不良仍然是一个挑战。事实上,目前还没有一个被广泛接受的关于子宫内膜发育不良的定义,也没有任何治疗方法被证明可以改善这种情况。本研究旨在分析联合应用己酮可可碱和生育酚是否能增加子宫内膜的体积。这项单中心回顾性研究纳入了既往有流产史、受精失败或子宫内膜发育不良的患者。患者在黄体中期进行超声检查,以评估子宫内膜厚度和子宫内膜体积(EV)。如果体积小于 2ml,他们将接受己酮可可碱(PTX)和生育酚治疗至少 2 个月,然后进行第二次超声评估。共分析了 144 例患者。治疗的平均持续时间为 132 天。生育酚和 PTX 的联合应用使 EV 显著增加了 0.47ml(<0.0001;95%CI 0.38-0.57)。治疗前后 EV 的平均( ± SD)分别为 1.34 ± 0.38ml 和 1.82 ± 0.63ml。关于妊娠率的数据无法解释。我们的研究表明,使用包括 PTX 和生育酚的治疗方法可以改善子宫内膜增殖不良。这些有前途的结果应该通过前瞻性研究进一步证实。