Email this article Outcome of vaginal sildinafil in assisted reproductive technology cycles
Abstract
Background: The present study assessed the role of sildenafil in endometrial blood flow and successful pregnancy in IVF done in surrogate mothers.
Methods: In the present study surrogate mothers were included. Thirty patients were randomized to receive sildenafil 25 mg thrice a day vaginally in addition to standard drugs and technique and another 30 were not given sildenafil.
Results: Mean age, anthropometry, duration of infertility and pre-treatment endometrial thickness was similar in the two study groups. After treatment completion, it was observed that the endometrial pattern in ultrasound was similar in the two study groups (p value=0.58). Heterogenic endometrial pattern was observed in 6.7% of the Sildenafil patients and 3.3% in the control patients, while echogenic pattern was seen in 10% of the sildenafil patients and 6.7% of the control patients. Similarly, endometrial thickness was 10.2±1.7 and 9.7±1.8 mm in sildenafil and control group respectively, p value=0.62. Using doppler ultrasound, uterine artery PI was significantly lower in Sildenafil group patients as compared to control group patients. Similarly, we found uterine artery RI was also significantly lower in the Sildenafil group patients as compared to control group patients. We followed the patients and found that clinical pregnancy rate was significantly higher among Sildenafil group (60%) as compared to control group (26.6%), p value<0.05.
Conclusions: Vaginal sildenafil resulted in significantly higher pregnancy rates in our study population. The uterine artery PI and RI were significantly lower in patients taking sildenafil.
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Singh M, Chaudhry P, Asselin E. Bridging endometrial receptivity and implantation: network of hormones, cytokines, and growth factors. J Endocrinol. 2011;210(1):5-14.
Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril. 2007;87(1):53-9.
Vilchez RB, Cosp XB, Glujovsky D, García VA, Colmenares FM, Zapata MJ. Vasodilators for women undergoing fertility treatment. Cochrane Database Syst Rev. 2018;10.
Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ ET). Hum Reprod. 1991;6(2):232-7.
Sher G, Dodge S, Maassarani G, Knutzen V, Zouves C, Feinman M. Management of suboptimal sonographic endometrial patterns in patients undergoing in-vitro fertilization and embryo transfer. Hum Reprod. 1993;8(3):347-9.
Paulus WE, Strehler E, Zhang M, Jelinkova L, El-Danasouri I, Sterzik K. Benefit of vaginal sildenafil citrate in assisted reproduction therapy. Fertil Steril. 2002;77(4):846-7.
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.
Fetih AN, Habib DM, Abdelaal II, Hussein M, Fetih GN, Othman ER. Adding sildenafil vaginal gel to clomiphene citrate in infertile women with prior clomiphene citrate failure due to thin endometrium: a prospective self-controlled clinical trial. Facts Views Vis Obgyn. 2017;9(1):21-7.
Chanona J, Garcia M, Ruvalcaba L, Bermudez A, Muniz M, Beltrian M, et al. The Mexican experience in the use of vaginal sildenafil in patients with poor endometrial response. International Congress Series. 2004;1271:19-21.
Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003;18(11):2337-41.
Malinova M, Abouyta T, Krasteva M. The effect of vaginal sildenafil citrate on uterine blood flow and endometrium in the infertile women. Akush Ginekol (Sofiia). 2013;52(1):26-30.
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.
Kim KR, Lee HS, Ryu HE, Park CY, Min SH, Park C, et al. Efficacy of luteal supplementation of vaginal sildenafil and oral estrogen on pregnancy rate following IVF-ET in women with a history of thin endometria: a pilot study. J Wowens Med. 2010;3(4):155-8.
