Nitric oxide donors increase the pregnancy rate in patients with unexplained infertility undergoing clomiphene citrate stimulation and intrauterine insemination: a randomized controlled pilot study

Abstract

This study evaluated the effects of nitric oxide donor’s treatment on the pregnancy rate and uterine blood flow in patients with unexplained infertility undergoing clomiphene citrate stimulation and intrauterine insemination. A total of 120 patients were randomly allocated to a control group who received 100 mg clomiphene citrate daily from day 5 to 9 of cycle plus placebo vaginal tablets, and a study group received clomiphene citrate plus isosorbide mononitrate 10 mg vaginal tablets. Vaginal ultrasound was done before treatment and every other day starting from day 12 of cycle to count mature follicles and ovulation was triggered by IM injection of 10 000 IU hCG when one follicle measured 18 ≥ mm followed by intrauterine insemination after 36 h. The endometrial thickness, uterine arteries resistance and pulsation indices, and endometrial vascular flow and vascular flow indices were measured before treatment and at day of hCG injection. Results were analyzed after one cycle treatment using the Mean ± SD, the Student t test and the Fisher Exact test. Significant result was considered at p values <0.05. The study group had significant higher pregnancy rate/cycle, higher endometrial and lower uterine artery blood flow indices (p < 0.05).

Chinese abstract

这项研究的目的为评估一氧化氮供体治疗对原因不明性不孕患者接受氯米芬柠檬酸盐刺激和宫内人工授精的妊娠率和子宫血流量的影响。120名患者被随机分配到对照组, 在治疗周期的第5至9天接受每天100mg克罗米芬和阴道内安慰药片治疗, 研究组接受每天克罗米芬和10mg异山梨醇单硝酸盐阴道片治疗。治疗前进行阴道超声检查, 从治疗周期的第12天起每隔一天计数成熟卵泡的数量, IM注射10 000 IU hCG以触发排卵, 当卵泡直径≧18mm时随后在36小时后进行宫内授精。在治疗前和hCG注射当日测量子宫内膜厚度, 子宫动脉阻力和脉动指数, 以及子宫内膜血管流量和血管流量指数。治疗一个周期后用平均值±标准差, Student t检验和Fisher Exact检验法分析结果。在p < 0.05时认为结果具有统计学意义。研究组具有较高的妊娠率/周期, 较高的子宫内膜厚度和较低的子宫动脉血流量指数 (p < 0.05) 。

Keywords:

• Unexplained infertility
• NO donors
• IUI

Declaration of interest

The authors declare no conflict of interest.