Details
Category: Volume 08 Issue 05 May 2020
Hits: 1258

Title: Role of Sildenafil on Endometrial characters in ovulation induction cycle

Authors: Dr Y. Srilaxmi, MD, Dr A. Vikram Arun, MBBS, Dr Alla Satyanarayana Reddy, MD

 DOI: https://dx.doi.org/10.18535/jmscr/v8i5.62

Abstract

 

Sildenafil causes vasodilatation by relaxing smooth muscles of blood vessels, enhances endometrial development. Improving endometrial thickness is one of the cornerstones in the management of infertility

Aim of the study: To evaluate the role of Sildenafil on endometrial characters in ovulation induction cycle.

Materials and Methods: 50 infertile women with thin endometrium were randomly divided into two groups. Group A comprised of 25 women in whom clomiphene citrate 50 mg daily from D2 to D6  along with estradiol valerate 2 mg thrice daily from D2 and  Group B  of 25 women in whom clomiphene citrate 50 mg daily from D2 to D6, estradiol valerate 2 mg thrice daily from D2 and sildenafil citrate 25 mg vaginally thrice daily from  D7 to the day of ovulation trigger were given. Trans-vaginal ultrasound was done on alternate days from D8 of cycle for monitoring of follicular development and endometrial characters.HCG trigger was given once the dominant follicle reached >18 mm. Total three cycles of ovulation were studied.

Results: Monitoring of endometrial characters in all the ovulation induced cycles showed significant improvement in Group B. In Group B Mean endometrial thickness was 10.2±1.6mm whereas it is 8.53±1.4 mm in Group A; trilaminar pattern was 93.54% in group B compared to 40.29% in Group A; Zone 4 endometrium was 79.03% in Group B compared to 26.86% in Group A; clinical pregnancy rate per cycle was 20.96% in Group B compared to 13.45% in Group A.

Conclusion: Addition of vaginal Sildenafil to estradiol valerate has significant effect in improving endometrial characters and clinical pregnancy rates in ovulation induction cycles.

Keywords: Sildenafil; Estradiol; Endometrium.

References

  1. Sher G, Fisch JD. Vaginal sildenafil: A preliminary report of a novel method to improve Reference terine artery blood flow and endometrial development in patients undergoing IVF. HUM Reprod 2000,15; 806-9
  2. Jyothi M Benni et al., An overview on sildenafil and female infertility Indian journal of Health sciences and biomedical research. KLEU 2016, vol 9, pg : 131-136
  3. Shahinaz EI shourbagy et al., The role of sildenafil citrate suppositories on endometrial response [thickness and mean resistance index of endometrial spiral artery] in cases of unexplained infertility. Menoufia medical journal, 2017,Vol 30, pg 343-349
  4. Amr Mohamed S Abdel Hamid et al., effect of adding sildenafil to clomiphene citrate versus clomiphene citrate alone on endometrium in unexplained infertility. Obstetrics and gynecology International Journal 2017, Vol 7, issue 2
  5. Takasaki Aetal, Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in patients with a thin endometrium. Fertility and sterility, 93[6]: 1851-1858
  6. Dehghani Firouzabadi R et al.,[2013]: Effect of sildenafil citrate on endometrial preparation and outcome of frozen thawed embryo transfer cycles: a randomized clinical trial, Iranian Journal of Reproductive Medicine 11[2]; 151-158
  7. Jerzek et al., sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with history of recurrent miscarriage FertilSteril, 2008; 90; 1848-1853
  8. Mangal et al., To study and compare the effect of vaginal sildenafil and estradiol valerate on endometrial thickness, blood flow and pregnancy rates in infertile women undergoing intrauterine insemination. Int j Reprodcontracept Obstet Gynecol., 2016; 5[7]; 2274-2277
  9. Mohamed Ashraf Mohamed Farouk kortam at al., effect of estradiol valerate with and without oral sildenafil on endometrial thickness and pregnancy rates in infertile women EBWH Journal Nov 2018, Vol8,
  10. Mishra V V Choudhary S et al, [2015] Vaginal Sildenafil: Role in improving endometrial blood flow in women undergoing IVF with frozen thawed embryo cycles. IJSR, 4[8] 292-4
  11. Fahmy A A et al., [2015] The value of oral Sildenafil in the treatment of female infertility. A randomized controlled trial Life sci j, 12[4]; 78-82.
  12. Dalia Ibrahim et al, the effect of Sildenafil versus estradiol on endometrial thickness and pattern in infertile females. EJPMR 2018,5[8], 581-584.

Corresponding Author

Dr Alla Satyanarayana Reddy

Professor in OBG, Vinayaka Mission`s Medical College & Hospital, Karaikal, Pondicherry, India. 609609