לפרופ'
דיון מתוך פורום פריון האישה והפריה חוץ גופית
שלום רב! שאלתי אותך לפני כמה ימים על ויטמין E בכמויות גדולות ואספירין במינון נמוך בהקשר של רירית דקה. אמרת לי שאתה לא מכיר מחקר בנושא. אני מצרפת לך מחקר ואשמח לשמוע מה דעתך, מדובר אצלי על רירית שלא מגיבה להורמונים בשום צורה ואני בחורה צעירה. אם תוכל להסביר לי אולי במחקר מוזכר שם PENTOXIFYLLINE מה זה בעצם? Combined treatment by pentoxifylline and tocopherol for recipient women with a thin endometrium enrolled in an oocyte donation programme. Ledee-Bataille N, Olivennes F, Lefaix JL, Chaouat G, Frydman R, Delanian S. INSERM U131, Hopital Antoine Beclere, Clamart, France. [email protected] BACKGROUND: To evaluate the effect of an antifibrotic treatment by a combination of pentoxifylline (PTX) and tocopherol (vitamin E) in patients with a thin endometrium who were enrolled in an oocyte donation programme. METHODS: Eighteen oocyte recipients who failed to develop a pre-ovulatory endometrial thickness of at least 6 mm after receiving vaginal micronized estradiol were enrolled in the study. The patients received a combination of PTX (800 mg/day) and vitamin E (1000 IU/day) for 6 months. The main outcome measurements were the change in endometrial thickness and the pregnancy and delivery rates after treatment. RESULTS: Endometrial thickness increased significantly (P <0.001), with a mean of (+/-SD) 4.9 +/-0.6 mm before and 6.2 +/- 1.4 mm after treatment, with 72% (13/18) of patients being good responders. Five patients either did not respond to the treatment or responded only slightly. Three patients, of which two had received previous radiotherapy, became spontaneously pregnant, and two became pregnant after embryo transfer. Three patients did not have embryo transfer. A total of four babies were delivered. The pregnancy rate was thus 33% and the delivery rate 27%. CONCLUSION: Treatment by combination of PTX and vitamin E appears to improve the pregnancy rate in patients with a thin endometrium by increasing the endometrial thickness and improving ovarian function. This was especially noticeable in patients who had previously received total body irradiation. אודה לך מאוד אם תוכל לחוות דעתך!!!!!
המחקר שאת מביאה באמת לא בדק את הטיפול עם אספרין כי אם עם פנטוקסיפילין (ראי מחקר נוסף בנושא למטה). הפנטוקסיפילין הינו חומר דומה קצת לקפאין, ומשמש כחומר שמפחית את צמיגות הדם וכך משפר את זרימת הדם. הטיפול בו נפוץ אצל חולים עם כיבים ברגליים אצלם מנסים לזרז את ההחלמה על ידי שיפור בזרימת הדם. המחשבה באי פריון היא ששיפור זרימת הדם ישפר את איכות הרירית. התרופה מוכרת בישראל כ- TRENTAL ובהחלט ניתן לשקול ניסיון טיפול איתה. Fertil Steril 2002 Jun;77(6):1219-26 Uterine restoration by radiation sequelae regression with combined pentoxifylline-tocopherol: a phase II study. Letur-Konirsch H, Guis F, Delanian S. Fertility Center, Department of Obstetrics and Assisted Reproductive Technics, Institut Mutualiste Montsouris, Paris, France OBJECTIVE: To determine whether combined pentoxifylline (PTX) and tocopherol (vitamin E) treatment can improve uterine radiation-induced sequelae, resulting in an improved embryo implantation rate.DESIGN: Retrospective phase II clinical trial.SETTING: Volunteers in an oocyte donation program in a public hospital.PATIENT(S): Six women aged 31 +/- 4 years, who were irradiated 25 years previously for childhood cancer with 20 to 40 Gy including the pelvic area.INTERVENTION(S): Four women had taken hormone replacement therapy for primary amenorrhea, and two had retained their natural cycle. Treatment consisted of at least 12 months of pentoxifylline at 800 mg/day combined with 1000 IU/day of tocopherol.MAIN OUTCOME MEASURE(S): Endometrial thickness, uterine volume, and uterine artery blood flow were assessed by ultrasonography before and after pentoxifylline-tocopherol treatment, under usual estrogen-progesterone (OP) administration.RESULT(S): This treatment was well tolerated. All six patients improved significantly in endometrial thickness (6.2 +/- 0.6 vs. 3.2 +/- 1.1 mm), myometrial dimensions (44 [+/- 5] x 30 [+/- 3] x 20 [+/- 2] vs. 30 [+/- 7] x 22 [+/- 3] x 16 [+/- 2] mm), and diastolic uterine artery flow.CONCLUSION(S): In young women who want to bear children, the combination of pentoxifylline and vitamin E can reduce fibroatrophic uterine lesions after childhood irradiation.
מנהל פורום פריון האישה והפריה חוץ גופית
