Hélène Letur-Könirsch1, F Guis, Sylvie Delanian. 1. Fertility Center, Department of Obstetrics and Assisted Reproductive Technics, Institut Mutualiste Montsouris, Paris, France. helene.letur@imm.fr
Abstract
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.
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.
Authors: D Garg; E B Johnstone; L Lomo; D B Fair; M P Rosen; R Taylor; B Silver; J M Letourneau Journal: J Assist Reprod Genet Date: 2020-04-28 Impact factor: 3.412
Authors: Rosa B Gutarra-Vilchez; Xavier Bonfill Cosp; Demián Glujovsky; Andres Viteri-García; Fernando M Runzer-Colmenares; Maria José Martinez-Zapata Journal: Cochrane Database Syst Rev Date: 2018-10-12
Authors: Patricia T Jimenez; Samantha B Schon; Randall R Odem; Valerie S Ratts; Emily S Jungheim Journal: Reprod Biol Endocrinol Date: 2013-05-10 Impact factor: 5.211