万艾可对促排卵期子宫发育不良患者内膜容受性的影响

Effects of Vaginal Sildenafil on Endometrium Receptivity in Patients with a Thin Endometrium

目的:探讨万艾可在促排卵过程中对子宫内膜过薄患者内膜厚度及血流动力学的影响。方法:122例既往促排卵周期中子宫内膜生长不良的不孕症患者随机分为两组,A组(65例):于克罗米芬(CC)/人绒毛膜促性腺激素(hCG)促排卵第8天阴道放置万艾可(100 mg/d)至排卵,B组(57例)单纯CC/hCG促排卵。检测用药前后两组患者子宫内膜厚度、内膜形态学变化、子宫动脉血流搏动指数(PI)和血流阻力指数(RI)、以及妊娠率。结果:A组子宫内膜明显增厚,子宫内膜三线征发生率明显增高(P<0.05),PI和RI值显著降低(P<0.01),妊娠率(26.2%)也显著高于B组(10.5%)(P<0.05)。结论:万艾可能促进子宫内膜生长、改善子宫内膜容受性,有助于胚胎着床,提高妊娠率。

Objective To investigate the effects of Vaginal sildenafil on the endometrial growth and uterine blood flow in ovulation induction of patients with a thin endometrium following intravaginal administration.Methods 122 infertility patients with endometrial maldevelopment were selected and divided into two groups(group A,B).Clomifene(CC) and human chorionic gonadotrophin(hCG) were administrated for ovulation induction in 65 cases of group A and 57 cases of group B,then sildenafil(100 mg/d) were given intravaginally from 8th day to the end of ovulatory cycle in group A additionally.The pattern and thickness of endometrium,the pressure and resistance indexes(PI,RI) of uterine artery were determined in all patients.Results The thickness of endometrium and the rate of type A endometrium were significantly higher in group A(P<0.05).PI and RI were significantly decreased in group A,the pregnant rate of group A was significantly higher than that of group B(P<0.05).Conclusion Sildenafil could improve the growth of endometrium and the endometrial receptivity in patients with a thin endometrium,furthermore the rate of pregnancy was increased.