Effectiveness of Low Dose Aspirin or Vaginal Sildenafil on Perifollicular Blood Flow Using Doppler ultrasound and EG-VEGF and their Impacts on ICSI Cycle Outcome
هدى علي رسول
Authors :
Background: Aspirin low dose or vaginal sildenafil, the two drugs have been shown to be advantageous for women undergoing assisted conception. Using powerful Doppler imaging, it is now possible to identify perifollicular perfusion and hence the accurate selection of oocyte with good intracytoplasmic sperm injection (ICSI) outcome. Objective: The current study aimed to investigate the effects of aspirin and vaginal sildenafil citrate on improvement of the perifollicular blood flow, EG-VEGF and conception in females following ICSI cycles. Subjects and methods: Ninety infertile women were participated in ICSI cycles. Full investigation was made for participating women. Ovarian stimulation protocol was performed. Doppler ultrasonography was used to evaluate the perifollicular blood flow. Serum and follicular fluid EG-VEGF were measured. data analyzed using SSPS program. Results: Total oocytes count was significantly higher in aspirin group in comparison with sildenafil and control group. No significant difference in mean serum and follicular fluid EG-VEGF. Also, no significant difference in the proportions of PFBF and endometrial vascular zones. With respect to endometrial vascular zones, there was significant variation in favor of sildenafil and aspirin groups. Positive pregnancy test was reported in 40.0% of women in aspirin group, in (33.3 %) of women in sildenafil group and in (20.0 %) of women in placebo group, the difference was insignificant. Conclusion: Aspirin treatment resulted in higher number of total retrieved oocytes, aspirin and sildenafil did not improve endometrial thickness, but they resulted in an improvement of sub endometrial vascularity, however, biochemical pregnancy test was not affected by either pharmacological agent. Keywords: Aspirin, Sildenafil, ICSI cycle, EG-VEGF., Doppler ultrasound

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