International Journal of
Reproductive Biomedicine
Sat, Apr 20, 2024
[Archive]
Volume 18, Issue 3 (March 2020)
IJRM 2020, 18(3): 201-208 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Taheripanah R, Kabir-salmani M, Favayedi M, Zamaniyan M, Malih N, Taheripanah A. Effects of clomiphene citrate plus estradiol or progesterone on endometrial ultrastructure: An RCT. IJRM 2020; 18 (3) :201-208
URL: http://ijrm.ir/article-1-1047-en.html
URL: http://ijrm.ir/article-1-1047-en.html
Robabeh Taheripanah1 
, Maryam Kabir-salmani2 , Masoomeh Favayedi1 , Marzieh Zamaniyan * 3, Narges Malih4 , Anahita Taheripanah5
, Maryam Kabir-salmani2 , Masoomeh Favayedi1 , Marzieh Zamaniyan * 3, Narges Malih4 , Anahita Taheripanah5
1- Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2- Department of Biomaterials and Tissue Engineering, Stem Cell Division, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.
3- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran. , marziehzamaniyan@gmail.com
4- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5- Department of Molecular and Cellular Sciences, Faculty of Advanced Sciences and Technology Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran.
2- Department of Biomaterials and Tissue Engineering, Stem Cell Division, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran.
3- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran. , marziehzamaniyan@gmail.com
4- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5- Department of Molecular and Cellular Sciences, Faculty of Advanced Sciences and Technology Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran.
Abstract: (2730 Views)
Background: Pinopods concentrations in endometrial surface is a marker of implantation. estradiol valerate (EV) was used for change the adverse effects of Clomiphene Citrate (CC) on the endometrium. Endometrial morphology was less examined in this fields.
Objective (s): To assess whether there is a significant difference in endometrial pinopods concentrations and other parameters after adding estradiol valerate (EV) and progesterone to higher doses of clomiphene citrate (CC).
Study design: In this prospective randomized clinical trial, a total of 30 women, who did not respond to 100 mg CC from February 2016 until June 2016 were evaluated. They received 150 mg CC alone or CC with EV or CC plus progesterone. On day 21 of the menstrual cycle, endometrial biopsy and a blood sampling and scanning by electron microscopy were performed.
Results: On day 21 of the menstrual cycle there was no significant difference regarding pinopods concentrations (P=0.641) and serum estrogen levels (P=0.276) between groups. Serum progesterone levels on day 21 of the menstrual cycle among patients treated with CC, was higher than the other two groups (P=0.007).
Conclusions: The addition of EV and progesterone to higher dosages of CC, did not changes the pinopods concentration and serum estrogen levels on day 21 of the menstrual cycle. It can be concluded that the anti- estrogenic effects of CC just appear on the endometrium. In this study, there were higher levels of serum progesterone on day 21 of the menstrual cycles in the CC alone compared to other two groups.
Objective (s): To assess whether there is a significant difference in endometrial pinopods concentrations and other parameters after adding estradiol valerate (EV) and progesterone to higher doses of clomiphene citrate (CC).
Study design: In this prospective randomized clinical trial, a total of 30 women, who did not respond to 100 mg CC from February 2016 until June 2016 were evaluated. They received 150 mg CC alone or CC with EV or CC plus progesterone. On day 21 of the menstrual cycle, endometrial biopsy and a blood sampling and scanning by electron microscopy were performed.
Results: On day 21 of the menstrual cycle there was no significant difference regarding pinopods concentrations (P=0.641) and serum estrogen levels (P=0.276) between groups. Serum progesterone levels on day 21 of the menstrual cycle among patients treated with CC, was higher than the other two groups (P=0.007).
Conclusions: The addition of EV and progesterone to higher dosages of CC, did not changes the pinopods concentration and serum estrogen levels on day 21 of the menstrual cycle. It can be concluded that the anti- estrogenic effects of CC just appear on the endometrium. In this study, there were higher levels of serum progesterone on day 21 of the menstrual cycles in the CC alone compared to other two groups.
Keywords: Ovulation induction, Clomiphene, Estradiol, Progesterone, Electron microscopy, Endometrium.
Type of Study: Original Article |
Subject:
Assisted Reproductive Technologies
References
1. 1. Seyedoshohadaei F, Zandvakily F, Shahgeibi S. Comparison of the effectiveness of clomiphene citrate, tamoxifen and letrozole in ovulation induction in infertility due to isolated unovulation. Iran J Reprod Med 2012; 10: 531-536.
2. 2. Gadipudi A, Dasari P, Sagili H. Tamoxifen for ovulation induction in infertile PCOS women who did not conceive with 3 or more cycles of clomiphene citrate: A prospective clinical study. Fertil Sci Res 2017; 4: 22-29.
3. 3. Mouhayar Y, Sharara FI. Modern management of thin lining. Middle East Fertil Soc J 2017; 22: 1-2.
4. 4. Madero S, Rodriguez A, Vassena R, Vernaeve V. Endometrial preparation: effect of estrogen dose and administration route on reproductive outcomes in oocyte donation cycles with fresh embryo transfer. Hum Reprod 2016; 31: 1755-1764.
5. 5. Kelleher AM, Burns GW, Behura S, Wu G, Spencer TE. Uterine glands impact uterine receptivity, luminal fluid homeostasis and blastocyst implantation. Sci Rep 2016; 6: 38078.
6. 6. Steiner AZ, Terplan M, Paulson RJ. Comparison of tamoxifen and clomiphene citrate for ovulation induction: a meta-analysis. Hum Reprod 2005; 20: 1511-1515.
7. 7. El-Gharib MN, Mahfouz AE, Farahat MA. Comparison of letrozole versus tamoxifen effects in clomiphene citrate resistant women with polycysticovarian syndrome. J Reprod Infertil 2015; 16: 30-35.
8. 8. Achache H, Revel A. Endometrial receptivity markers, the journey to successful embryo implantation. Hum Reprod Update 2006; 12: 731-746.
9. 9. Bao SH, Le Sheng SL, Peng YF, De Lin QD. Effects of letrozole and clomiphene citrate on the expression of HOXA10 and integrin αvβ3 in uterine epithelium of rats. Fertil Steril 2009; 91: 244-248.
10. 10. Davar R, Javedani M, Fallahzadeh MH. Metformin-letrozole in comparison with Metformin-clomiphene citrate in clomiphene-resistance PCOS patients undergoing IUI. Iran J Reprod Med 2011; 9: 31-36.
11. 11. Davar R, Aflatoonian A. The effect of letrozole in induction of ovulation in clomiphene resistant patients. Int J Reprod Med 2004; 2: 78-80.
12. 12. Creus M, Ordi J, Fábregues F, Casamitjana R, Carmona F, Cardesa A, et al. The effect of different hormone therapies on integrin expression and pinopode formation in the humanendometrium: a controlled study. Hum Reprod 2003; 18: 683-693.
13. 13. Gerli S, Gholami H, Manna C, Di Frega AS, Vitiello C, Unfer V. Use of ethinyl estradiol to reverse the antiestrogenic effects of clomiphene citrate in patients undergoingintrauterine insemination: a comparative, randomized study. Fertil Steril 2000; 73: 85-89.
14. 14. Unfer V, Casini ML, Costabile L, Mignosa M, Gerli S, Di Renzo GC. High dose of phytoestrogens can reverse the antiestrogenic effects of clomiphene citrate on the endometrium in patients undergoing intrauterine insemination: a randomized trial. J Soc Gynecol Investig 2004; 11: 323-328.
15. 15. Check JH, Dietterich C, Lurie D. The effect of consecutive cycles of clomiphene citrate therapy on endometrial thickness and echopattern. Obstet Gynecol 1995; 86: 341-345.
16. 16. Yagel S, Ben-Chetrit A, Anteby E, Zacut D, Hochner-Celnikier D, Ron M. The effect of ethinyl estradiol on endometrial thickness and uterine volume during ovulation induction by clomiphene citrate. Fertil Steril 1992; 57: 33-36.
17. 17. Shimoya K, Tomiyama T, Hashimoto K, Moriyama A, Kawamoto A, Tokugawa Y, et al. Endometrial development was improved by transdermal estradiol in patients treated with clomiphene citrate. Gynecol Obstet Invest 1999; 47: 251-254.
18. 18. Harira M. Use of Letrozole versus clomiphene-estradiol for treating infertile women with unexplained infertility not responding well to clomiphene alone, comparative study. Middle East Fertility Society Journal 2018; 23: 384-387.
19. 19. Palomino WA, Fuentes A, González RR, Gabler F, Boric MA, Vega M, et al. Differential expression of endometrial integrins and progesterone receptor during the window of implantation in normo-ovulatory women treated with clomiphene citrate. Fertil Steril 2005; 83: 587-593.
20. 20. Massai MR, de Ziegler D, Lesobre V, Bergeron C, Frydman R, Bouchard P. Clomiphene citrate affects cervical mucus and endometrial morphology independently of the changes in plasma hormonal levels induced by multiple follicular recruitment. Fertil Steril 1993; 59: 1179-1186.
21. 21. Ganesh A, Chauhan N, Das S, Chakravarty B, Chaudhury K. Endometrial receptivity markers in infertile women stimulated with letrozole compared with clomiphene citrate and natural cycles. Syst Biol Reprod Med 2014; 60: 105-111.
22. 22. Cortínez A, De Carvalho I, Vantman D, Gabler F, Iñiguez G, Vega M. Hormonal profile and endometrial morphology in letrozole-controlled ovarian hyperstimulation in ovulatory infertile patients. Fertil Steril 2005; 83: 110-115.
23. 23. Usadi RS, Murray MJ, Bagnell RC, Fritz MA, Kowalik AI, Meyer WR, et al. Temporal and morphologic characteristics of pinopod expression across the secretory phase of the endometrial cycle in normally cycling women with proven fertility. Fertil Steril 2003; 79: 970-974.
24. 24. Omran E, El-Sharkawy M, El-Mazny A, Hammam M, Ramadan W, Latif D, et al. Effect of clomiphene citrate on uterine hemodynamics in women with unexplained infertility. Int J Womens Health 2018; 10: 147-152.
25. 25. Seyedoshohadaei F, Tangestani L, Zandvakili F, Rashadmanesh N. Comparison of the effect of clomiphene-estradiol valerate vs letrozole on endometrial thickness, abortion and pregnancy rate in infertile women with polycystic ovarian syndrome. J Clin Diagn Res 2016; 10: QC10-QC13.
26. 26. Nejatbakhsh R, Kabir-Salmani M, Dimitriadis E, Hosseini A, Taheripanah R, Sadeghi Y, et al. Subcellular localization of L-selectin ligand in the endometrium implies a novel function for pinopodes in endometrial receptivity. Reprod Biol Endocrinol 2012; 10: 46.
27. 1. Seyedoshohadaei F, Zandvakily F, Shahgeibi S. Comparison of the effectiveness of clomiphene citrate, tamoxifen and letrozole in ovulation induction in infertility due to isolated unovulation. Iran J Reprod Med 2012; 10: 531-536.
28. 2. Gadipudi A, Dasari P, Sagili H. Tamoxifen for ovulation induction in infertile PCOS women who did not conceive with 3 or more cycles of clomiphene citrate: A prospective clinical study. Fertil Sci Res 2017; 4: 22-29.
29. 3. Mouhayar Y, Sharara FI. Modern management of thin lining. Middle East Fertil Soc J 2017; 22: 1-2. [DOI:10.1016/j.mefs.2016.09.001]
30. 4. Madero S, Rodriguez A, Vassena R, Vernaeve V. Endometrial preparation: effect of estrogen dose and administration route on reproductive outcomes in oocyte donation cycles with fresh embryo transfer. Hum Reprod 2016; 31: 1755-1764. [DOI:10.1093/humrep/dew099] [PMID]
31. 5. Kelleher AM, Burns GW, Behura S, Wu G, Spencer TE. Uterine glands impact uterine receptivity, luminal fluid homeostasis and blastocyst implantation. Sci Rep 2016; 6: 38078. [DOI:10.1038/srep38078] [PMID] [PMCID]
32. 6. Steiner AZ, Terplan M, Paulson RJ. Comparison of tamoxifen a
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
