Navali Nazli, Eghbali Elham, Farzadi Laya, Ghasemzadeh Aliyeh, Hamdi Kobra, Hakimi Parvin, Ghasemnejad-Berenji Hojat, Sadeghpour Sonia
Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Medical Radiation Sciences Research Group, Tabriz University of Medical Sciences, Tabriz, Iran.
Clin Exp Reprod Med. 2025 Jun;52(2):141-149. doi: 10.5653/cerm.2024.07129. Epub 2024 Dec 11.
For successful embryo implantation in women with high pulsatility, uterine vascular resistance and pulsatility must be reduced. We examined the effects of amlodipine on uterine pulsatility index (PI), resistance index (RI), and embryo transfer (ET) outcomes in women with prior implantation failure and at least one elevated uterine PI measurement (especially higher than 3).
Between February and November 2023, our reproductive facility conducted a single-center randomized clinical trial, enrolling 100 patients with previous implantation failure and at least one uterine PI measurement exceeding 3. Participants were randomly assigned to receive either amlodipine (5 mg) or placebo (n=50 per group). Hormone replacement therapy was the predominant method for endometrial preparation. Transvaginal ultrasonography was used to measure uterine artery resistance and pulsatility on day 1 or 2 of menstruation. Women in the amlodipine group received 5 mg nightly. Following repeat transvaginal ultrasound to assess PI and RI, ET was performed. If a positive pregnancy test was obtained, treatment continued for a total of 7 weeks.
Amlodipine reduced blood flow indices in the uterine artery. Among placebo recipients, 18% tested positive for beta-human chorionic gonadotropin, compared to 26% of medication recipients. However, this difference was statistically insignificant (p=0.472). Gestational sacs were observed in 12% of the placebo group and 22% of the medication group, but this difference was also insignificant (p=0.28).
Amlodipine appears to reduce uterine pulsatility and resistance during ET. Despite the absence of significant differences in pregnancy outcomes, this promising drug merits further study in women with implantation failure.
对于高搏动性的女性，要成功实现胚胎着床，必须降低子宫血管阻力和搏动性。我们研究了氨氯地平对既往着床失败且至少有一次子宫搏动指数（PI）测量值升高（尤其是高于3）的女性的子宫搏动指数、阻力指数（RI）及胚胎移植（ET）结局的影响。
2023年2月至11月，我们的生殖机构开展了一项单中心随机临床试验，招募了100例既往着床失败且至少有一次子宫PI测量值超过3的患者。参与者被随机分配接受氨氯地平（5毫克）或安慰剂（每组50人）。激素替代疗法是子宫内膜准备的主要方法。在月经第1天或第2天，采用经阴道超声测量子宫动脉阻力和搏动性。氨氯地平组的女性每晚服用5毫克。在重复经阴道超声评估PI和RI后，进行胚胎移植。如果妊娠试验呈阳性，则治疗持续7周。
氨氯地平降低了子宫动脉的血流指数。在接受安慰剂的患者中，18%的人β-人绒毛膜促性腺激素检测呈阳性，而接受药物治疗的患者中这一比例为26%。然而，这一差异无统计学意义（p=0.472）。安慰剂组12%的患者观察到妊娠囊，药物组为22%，但这一差异也无统计学意义（p=0.28）。
氨氯地平似乎在胚胎移植期间降低了子宫搏动性和阻力。尽管妊娠结局无显著差异，但这种有前景的药物值得在着床失败的女性中进一步研究。
