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Human Reproduction, Vol. 17, No. 10, 2615-2620, October 2002
© 2002 European Society of Human Reproduction and Embryology

Nitric oxide donors for patients undergoing IVF. A prospective, double-blind, randomized, placebo-controlled trial*

Jeanine Ohl1,6, Catherine Lefèbvre-Maunoury2, Christiane Wittemer1, Gabriel Nisand3, Marie-Christine Laurent4 and Pascale Hoffmann5

1 Département d’AMP de Strasbourg, Service de Gynécologie-Obstétrique, CMCO, 19 rue Louis Pasteur, BP 120, 67303 Schiltigheim, 2 Service d’AMP, Hôpital Jeanne de Flandres, 59037 Lille cedex, 3 Département d’Informatique Médicale, Hospices Civils, 67091 Strasbourg cedex, 4 Service de Gynécologie-Obstétrique B, Hôpital Sud, 16 boulevard de Bulgarie, BP 56129 35056 Rennes cedex 2 and 5 Service de Gynécologie-Obstétrique et Médecine de la Reproduction, CHU Nord, BP 217 38043 Grenoble cedex 9, France

BACKGROUND: Nitric oxide (NO) is involved in local control of the uterine cycle and in preparation of the uterus for pregnancy. NO donors, acting as vasodilating agents, may therefore have possible therapeutic uses, for example they may be of benefit to patients with a history of implantation failure. In a prospective, comparative, randomized, placebo-controlled study, we assessed the efficacy of nitroglycerin (NTG) administered to 138 IVF patients with a history of implantation failure. METHODS: Controlled ovarian stimulation was performed with long agonist protocol combined with recombinant FSH. Embryos were transferred on day 2 or 3 after oocyte retrieval. Eligible patients were those who had at least two ‘good quality’ embryos. The NTG patch was administered the day before embryo transfer and continued until either the results of the pregnancy test were known or until menstruation occurred. RESULTS: Ovarian response, implantation rate and pregnancy rate were comparable between both groups. No difference was observed in uterine Doppler findings, particularly the mean pulsatility index. CONCLUSIONS: NTG treatment the day before embryo transfer was no more effective than placebo in improving the implantation or pregnancy rates in a population of IVF patients with a previous history of implantation failures.

Key words: implantation/IVF/nitric oxide donors

6 To whom correspondence should be addressed. E-mail: pierre.ohl{at}evc.net

* The Multicentre Trialists from the GROG (Groupe de Recherche en Obstétrique et en Gynécologie): Dr Karima Bettahar-Lebugle, Dr Jeanine Ohl, Dr Catherine Rongières (Schiltigheim); Dr Catherine Lefèbvre-Maunoury (Lille); Dr Marie-Christine Laurent (Rennes); Dr Nicole Quénard, Dr Irène Grefenstette, Dr Pascale Hoffman (Grenoble); Dr Catherine Avril, Bois (Guillaume); Pr Michel Herlicoviez (Caen); Dr Stéphanie Dominé (Paris); Dr Renato Fanchin, Dr Nathalie Lédée (Clamart); Pr Bruno Salle (Lyon); Dr Brigitte Lebouvier (Angers).


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