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document
Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients . The objective of the present study was prospectively and randomly to evaluate the role of L-arginine in improving uterine and follicular Doppler flow and in improving ovarian response to gonadotrophin in poor responder women . A total of 34 patients undergoing assisted reproduction was divided in two groups according to different ovarian stimulation protocols : ( i ) flare-up gonadotrophin-releasing hormone analogue ( GnRHa ) plus elevated pure follicle stimulating hormone ( pFSH ) ( n = 17 ) ; and ( ii ) flare-up GnRHa plus elevated pFSH plus oral L-arginine ( n = 17 ) . During the ovarian stimulation regimen , the patients were submitted to hormonal ( oestradiol and growth hormone ) , ultrasonographic ( follicular number and diameter , endometrial thickness ) and Doppler ( uterine and perifollicular arteries ) evaluations . Furthermore , the plasma and follicular fluid concentrations of arginine , citrulline , nitrite/nitrate ( NO2-/NO3- ) , and insulin-like growth factor-1 ( IGF-1 ) were assayed . All 34 patients completed the study . In the L-arginine treated group a lower cancellation rate , an increased number of oocytes collected , and embryos transferred were observed . In the same group , increased plasma and follicular fluid concentrations of arginine , citrulline , NO2-/NO3- , and IGF-1 was observed . Significant Doppler flow improvement was obtained in the L-arginine supplemented group . Three pregnancies were registered in these patients . No pregnancies were observed in the other group . It was concluded that oral L-arginine supplementation in poor responder patients may improve ovarian response , endometrial receptivity and pregnancy rate .
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Intervention_Pharmacological
L-arginine
1389
Intervention_Pharmacological
L-arginine
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Intervention_Pharmacological
flare-up gonadotrophin-releasing hormone analogue ( GnRHa ) plus elevated pure follicle stimulating hormone ( pFSH )
1391
Intervention_Pharmacological
flare-up GnRHa plus elevated pFSH plus oral L-arginine
1392
Intervention_Physical
ultrasonographic
1393
Intervention_Pharmacological
L-arginine
1394
Intervention_Pharmacological
L-arginine
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Intervention_Pharmacological
L-arginine
1396
Outcome_Physical
uterine and follicular Doppler flow
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Outcome_Physical
ovarian response to gonadotrophin
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Outcome_Other
lower cancellation rate
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Outcome_Physical
, an increased number of oocytes collected
1400
Outcome_Other
embryos transferred
1401
Outcome_Physical
increased plasma and follicular fluid concentrations of arginine , citrulline , NO2-/NO3- , and IGF-1
1402
Outcome_Physical
Significant Doppler flow improvement
1403
Outcome_Physical
pregnancies
1404
Outcome_Physical
pregnancies
1405
Outcome_Physical
ovarian response
1406
Outcome_Physical
endometrial receptivity and pregnancy rate