Evaluation of the effect of sildenafil on nitric oxide secretion and improvement of endometrial receptivity in fresh ICSI cycles

Authors

  • Rabab Alwan Taher AL Emamian Al-Kadymiain Hospital, Iraq; Um Albanin Infertility and IVF Center, Iraq
  • Shereen Abdulhussien Kzar Al-Essami AL Emamian Al-Kadymiain Hospital, Iraq; Um Albanin Infertility and IVF Center, Iraq
  • Batool Hussein Kadhim AL Emamian Al-Kadymiain Hospital, Iraq

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20230780

Keywords:

Endometrial receptivity, Fresh ICSI cycle, Sildenafil

Abstract

Background: Endometrial receptivity is a chain of events that promotes embryo implantation and is regulated by a variety of substances, such as cytokines, growth factors, and steroid hormones. The study’s objective was to assess how vaginally delivered sildenafil in ICSI patients affects pregnancy outcome, endometrial thickness, subendometrial resistance index, and pulsatility index.

Methods: The sixty women who participated in this controlled randomised trial (interventional experimental research) at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies underwent IVF/ICSI cycles. Patients were split into two groups: study group: from the day of the last menstrual period to the day of the hCG injection, thirty (30) infertile women got four (4) doses of vaginal sildenafil 25mg tablets daily. Thirty (30) infertile ladies who weren’t given sildenafil therapy made up the control group.

Results: Nitric oxide levels in the study group's serum were significantly significant. In the subendometrial Doppler research, the mean pulsatility index was considerably lower in the study group whereas the mean resistance index and mean systolic to diastolic ratio did not change statistically between the control and study groups. Between the control and study groups, there was no statistically significant difference in the mean endometrial thickness. The sildenafil group had a greater pregnancy rate, although the difference was not statistically significant.

Conclusions: By enhancing subendometrial blood flow by lowering the pulsatility index and raising the nitric oxide (NO) factor, the use of vaginal sildenafil in a new ICSI cycle improves endometrial receptivity.

 

Metrics

Metrics Loading ...

References

Thoma ME, McLain AC, Louis JF, King RB, Trumble AC, Sundaram R, et al. Prevalence of infertility in the United States as estimated by the current duration approach and a traditional constructed approach. Fertil Steril. 2013;99(5):1324-31.

Harper JC, Harton G. The use of arrays in preimplantation genetic diagnosis and screening. Fertil Steril. 2010;94:1173-7.

Maruyama T. Therapeutic Strategies for Implantation Failure due to Endometrial Dysfunction. J Mammal Ova Res. 2009;26:129-33

Lédée N, Chaouat G, Serazin V, Lombroso R, Dubanchet S, Oger P, et al. Endometrial vascularity by three-dimensional power Doppler ultrasound and cytokines: a complementary approach to assess uterine receptivity. J Reprod Immunol. 2008;77(1):57-62.

Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC. The role of endometrial and subendometrial blood flows measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during IVF treatment. Hum Reprod. 2006;21(1):164-70.

Demir B, Dilbaz S, Cinar O, Ozdegirmenci O, Dede S, Dundar B, et al. Estradiol supplementation in intracytoplasmic sperm injection cycles with thin endometrium. Gynecol Endocrinol. 2013;29(1):42-5.

Wareing M, Myers JE, O'hara M, Kenny LC, Warren AY, Taggart MJ, et al. Effects of a phosphodiesterase-5 (PDE5) inhibitor on endothelium-dependent relaxation of myometrial small arteries. Am J Obstet Gynecol. 2004;190(5):1283-90.

Nakatsuka M, Habara T, Noguchi S, Konishi H, Kudo T. Impaired uterine arterial blood flow in pregnant women with recurrent pregnancy loss. J Ultrasound Med. 2003;22(1):27-31.

El-Maghrabi HA, El-Kasar YS, Elbaz ZM, Youssef L. Effect of sildenafil citrate on endometrial thickness and pregnancy rate in frozen-thawed embryo transfer cycles. Austin J Obstet Gynecol. 2020;7(1):1150.

Firouzabadi RD, Davar R, Hojjat F, Dhdavi M. Effect of sildenafil citrate on endometrial preparation and outcome of frozen-thawed embryo transfer cycles: a randomized clinical trial. Iran J Reprod Med. 2013;11:151-8.

Wafa YA, ALKhouly MM, Mosalam RM. Role of Low dose sildenafil in improvement of implantation rate in case of recurrent ICSI failure. Egypt J Hosp Med. 2019;75(2):2173-82.

Malinova M, Abouyta T, Krasteva M. The effect of vaginal sildenafil citrate on uterine blood flow and endometrium in the infertile women. Akush Ginekol. 2013;52(1):26-30.

Moini A, Zafarani F, Jahangiri N, Jahanian Sadatmahalleh S, Sadeghi M, Chehrazi M, et al. The effect of vaginal sildenafil on the outcome of assisted reproductive technology cycles in patients with repeated implantation failures: a randomized placebo-controlled trial. Int J Fertil Steril. 2020;13(4):289-95.

Tehraninajad ES, Khazei N, Ayati E, Movafegh A, Azimaraghi O. Effect of vaginal sildenafil in vitro fertilization success rates in women with previous failed in vitro fertilization attempts. Asian J Pharm Clin Res. 2018;11(6):486-8.

Khazaei M, Roshankhah S, Ghorbani R, Chobsaz F. Sildenafil effect on nitric oxide secretion by normal human endometrial epithelial cells cultured in vitro. Int J Fertil Steril. 2011;5(3):142-7.

AbdelKader Fahmy A, ElSokkary M, Sayed S. The value of oral sildenafil in the treatment of female infertility: a randomized clinical trial. Life Sci J. 2015;12(4):78-82.

Sher G, Fisch JD. Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. Fertil Steril. 2002;78(5):1073-6.

Battaglia C, Salvatori M, Maxia N, Petraglia F, Facchinetti F, Volpe A. Adjuvant L-arginine treatment for in-vitro fertilization in poor responder patients. Hum Reprod. 1999;14:1690-7.

Ohl J, Lefebvre-Maunoury C, Wittemer C, Nisand G, Laurent MC, Hoffmann P. Nitric oxide donors for patients undergoing IVF. A prospective, double-blind, randomized, placebo-controlled trial. Hum Reprod. 2002;17:2615-20.

Lee TH, Wu MY, Chen MJ, Chao KH, Ho HN, Yang YS. Nitric oxide is associated with poor embryo quality and pregnancy outcome in in vitro fertilization cycles. Fertil Steril. 2004;82(1):126-31.

Battaglia C, Regnani G, Marsella T, Facchinetti F, Volpe A, Venturoli S, et al. Adjuvant L-arginine treatment in controlled ovarian hyperstimulation: a double-blind, randomized study. Hum Reprod. 2002;17:659-65.

Downloads

Published

2023-03-28

How to Cite

Taher, R. A., Kzar Al-Essami, S. A., & Hussein Kadhim, B. (2023). Evaluation of the effect of sildenafil on nitric oxide secretion and improvement of endometrial receptivity in fresh ICSI cycles. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 12(4), 848–852. https://doi.org/10.18203/2320-1770.ijrcog20230780

Issue

Section

Original Research Articles