Effect of Sildenafil Citrate on the Outcome of in vitro Fertilization after Multiple IVF Failures Attributed to Poor Endometrial Development: A Randomized Controlled Trial

Aim of the work: this study aimed to evaluate the effect of sildenafil citrate on endometrial development in women with history of recurrent implantation failure after IVF.
Setting: This study was conducted in obstetrics and gynecology department of Ain Shams University.
Patients and methods: this is arandomized controlled trial on 80 women with previous two or more failed IVF. Women in group A (N=40) took oral sildenafil citrate at dose 25mg tab/ 6h daily from day six of induction of ovulation until day of HCG administration; while those in group B (N=40) took placebo tablets. Outcome measuers: The primary outcome was change in endometrial thickness before and after intervention. Results: Endometrial thickness in both groups was statistically insignificant between the two groups when measured in day 6 with p-value 0.070.Endometrial thickness on day of HMG injection measured and found that it was higher in group A(Sildenafil Group) than group B(Placebo Group) with significantly increased statistically difference between the two groups with p-value <0.001.
Conclusion: sildenafil citrate leads to smooth muscle relaxation and vasodilation. This may enhance endometrial development and increased pregnancy rate in females undergoing IVF which may be attributed to the increase in the endometrial thickness.