Evaluating the Role of Sildenafil on Endometrial Characters in Ovulation Induction Cycle

Sildenafil promotes endometrial development by causing vasodilation by relaxing the smooth muscles of blood vessels. Improving endometrial thickness is one of the cornerstones of infertility treatment.

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

Materials and Methods: A total of 50 infertile women with thin endometrium were allocated into two groups at random. Group A included 25 women who received clomiphene citrate 50 mg daily from D2 to D6, as well as estradiol valerate 2 mg thrice daily from D2, and Group B included 25 women who received 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. Trans-vaginal ultrasound was performed on alternate days beginning on D8 of the cycle to monitor follicular development and endometrial characteristics. Once the dominant follicle reached >18 mm, an HCG trigger was administered. Three cycles of ovulation were studied in total.

Results: Endometrial character monitoring in all ovulation-induced cycles revealed a significant improvement in Group B.

The mean endometrial thickness in Group B was 10.2±1.6 mm compared to8.53±1.4 mm in Group A; the tri laminar pattern was 93.54 percent in Group B compared to 40.29 percent in Group A; the zone 4 endometrium was 79.03 percent in Group B compared to 26.86 percent in Group A; and the clinical pregnancy rate per cycle was 20.96 percent in Group B compared to 13.45 percent in Group A.

Conclusion: The addition of vaginal Sildenafil to estradiol valerate has a significant effect on endometrial characteristics and clinical pregnancy rates in ovulation induction cycles.