Successful pregnancies after combined pentoxifylline-tocopherol treatment in women with premature ovarian failure who are resistant to hormone replacement therapy

Hélène Letur-Konirsch, H Letur-Könirsch, S. Delanian, Sylvie Delanian
Fertility and sterility · 2003 · vol. 79(2) , pp. 439–441 · doi:10.1016/s0015-0282(02)04579-x · PMID:12568863 · W2001778306
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This paper reports successful pregnancies in women with premature ovarian failure and hormone replacement therapy resistance following treatment with a combination of pentoxifylline and tocopherol.

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Abstract

OBJECTIVE: To determine whether treatment with combined pentoxifylline (PTX) and tocopherol (Vit.E) can improve uterine parameters in hormonal replacement therapy (HRT)-resistant women with premature ovarian failure (POF), for whom the outcome of assisted reproductive technology is usually negative. We previously reported that uterine radiation-induced fibrosis is reversible by combined PTX-Vit.E treatment. DESIGN: Case report. SETTING: Volunteer participants in an oocyte donation (OD) program in a French public hospital. PATIENT(S): Three women with POF (ages 36 +/- 2 years) using HRT exhibited uterine hormonoresistance, although they had high E(2) plasma levels. Their mean endometrial thickness was 4.9 mm, and they had an echogenic endometrium and thin uterine crosses. INTERVENTION(S): Between May 1998 and April 1999, treatment consisted of 800 mg of PTX combined with 1,000 IU of Vit.E daily for at least 9 months. MAIN OUTCOME MEASURE(S): Endometrial thickness, echogenicity, and pulsatility index of the uterine arteries, assessed by ultrasound and Doppler before and after treatment, and embryo implantation by IVF-OD. RESULT(S): PTX-Vit.E treatment was well tolerated and induced improvements, as mean edematous endometrial thickness increased to 7.4 mm, with nice uterine crosses. Three frozen-thawed ETs resulted in two viable pregnancies. CONCLUSION(S): In women with POF and uterine resistance to HRT, combined PTX-Vit.E reduces fibroatrophic uterine lesions and improves the uterine response to HRT, thus allowing embryo implantation and ongoing pregnancy.

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MeSH descriptors

Estrogen Replacement Therapy Pentoxifylline Primary Ovarian Insufficiency Tocopherols Adult Drug Resistance Drug Therapy, Combination Estradiol Estradiol Estrogen Replacement Therapy Female Humans Pentoxifylline Primary Ovarian Insufficiency Primary Ovarian Insufficiency Tocopherols

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