Value of Vaginal Sildenafil Citrate for Endometrial Preparation and Outcome in Frozen Thawed Embryo Transfer Cycles
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- Category: Vol. 85, September 2017
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Value of Vaginal Sildenafil Citrate for Endometrial Preparation and Outcome in Frozen Thawed Embryo Transfer Cycles, ASHRAF M. KANSOUH and MOHAMED A. EL-NAGGAR
Abstract
Background: Vaginal Sildenafil Citrate may increase endometrial thickness, improving endometrial blood flow and affect the outcome of frozen-thawed embryo transfer cycles.
Objective: To assess the effect of vaginal sildenafil citrate in improving endometrial central line (trilaminar) pattern, implantation rate and chemical pregnancy rate in frozen embryo transfer cycles.
Methods: This study was carried out at ART unit in The International Islamic Center for Population Studies and Re-search (IICPSR) at Al-Azhar University in addition to private in vitro- fertilization ( IVF) center during the period between June 2015 and Dec. 2016. On the 21 st day of l cycle proceeding the treatment, all infertile women (90) who had an antecedent of poor endometrial response and frozen embryos. Endometrial thickness, pattern and vascularity and frozen embryos were included in this study. Group A, 45 Women were included and given sildenafil citrate 25mg vaginally every 6 hours starting from day 2-14 of the cycle in addition to oral 2mg of estradiol valerat 6-8 hourly from the day 2-14 of the menstrual cycle. This was discontinued 48-72 hours prior to the embryo transfer. Group B, 45 women were given oral estradiol valerat tablets 2mg 6-8 hourly from the day 2-14 of the cycle to prepare the endometrium, Women were evaluated by using trans-vaginal sonography (TVS) on day 8 of cycle for assess-ment endometrial thickness and pattern and by using two dimension power Doppler for assessment endometrial vascu-larity.
Results: The endometrial thickness on cycle day 8 was significantly higher in women of the sildenafil citrate group (p<0.001). There was a significantly higher proportion of women who had triple line pattern (trilaminar ) of the endome-trial on cycle day 8 among women of sildenafil citrate group, when compared to those of control group (p<0.001). Finally, the biochemical pregnancy rates were higher in the sildenafil citrate group but not significantly.
Conclusion: Transvaginal of sildenafil citrate is a signif-icant to improve the endometrial thickness, pattern and vas-cularity in women undergoing frozen-thawed embryo transfer cycle. Further studies on larger scale patients are needed to prove value in improving pregnancy outcome.