Volume 11, Issue 2 (4-2013)                   IJRM 2013, 11(2): 151-0 | Back to browse issues page

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Dehghani Firouzabadi R, Davar R, Hojjat F, Mahdavi M. Effect of sildenafil citrate on endometrial preparation and outcome of frozen-thawed embryo transfer cycles: a randomized clinical trial. IJRM 2013; 11 (2) :151-0
URL: http://ijrm.ir/article-1-381-en.html
1- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2- Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , farzanehhojjat@gmail.com
3- Shahid Beheshti Taft Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Abstract:   (17504 Views)
Background: Sildenafil citrate may increase endometrial thickness and affect the outcome of frozen-thawed embryo transfer cycles.
Objective: The aim of this study was to estimate the effect of sildenafil citrate on ultrasonographic endometrial thickness and pattern and to investigate the estrogen level on the day of progesterone administration, the implantation rate and chemical pregnancy rate in frozen embryo transfer cycles.
Materials and Methods: This randomized controlled trial was conducted on 80 patients who had an antecedent of poor endometrial response and frozen embryos. 40 patients were given estradiol by a step up method with menstruation to prepare the endometrium, and the other 40 were given sildenafil citrate tablets (50 mg) daily in addition to the above treatment protocol from the first day of the cycle until the day progesterone was started. This was discontinued 48-72 hours prior to the embryo transfer.
Results: The endometrial thickness was significantly higher in the sildenafil citrate group (p<0.0001), the triple line patterns of the endometrium were significantly higher in the sildenafil citrate group (p<0.0001), while the intermediate patterns of the endometrium were not significantly different in the two groups. The echogen patterns of the endometrium were significantly higher in control group (p<0.0001). Finally, implantation rate and the chemical pregnancy rates were higher in the sildenafil citrate group but not significantly.
Conclusion: As our study shows, the oral use of sildenafil citrate is a good way to improve the endometrial receptivity. We recommend the routine use of oral sildenafil citrate in patients with a previous failure of assisted reproduction technology cycles due to poor endometrial thickness.
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Type of Study: Original Article |

References
1. Ledee 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: 57-62. [DOI:10.1016/j.jri.2007.07.006]
2. Maruyama T. Therapeutic Strategies for Implantation Failure due to Endometrial Dysfunction. J Mammal Ova Res 2009; 26: 129-133. [DOI:10.1274/jmor.26.129]
3. Bergh PA, Navot D. The impact of embryonic development and endometrial maturity on the timing of implantation. Fertil Steril 1992; 58: 537-542.
4. Critchley HOD, Saunders PTK. Hormone Receptor Dynamics in a Receptive Human Endometrium. Reprod Sci 2009; 16: 191-199. [DOI:10.1177/1933719108331121]
5. Dharmaraj N, Wang P, Carson DD. Cytokine and Progesterone Receptor Interplay in the Regulation of MUC1 Gene Expression. Mol Endocrinol 2010; 24: 2253-2266. [DOI:10.1210/me.2009-0448]
6. Gao MZ, Zhao XM, Li WY, Liu GM, Jia XF, Zhang HQ. Assessment of Uterine Receptivity by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound in Women Undergoing IVF Treatment. J Reprod Contracept 2007; 18: 205-212. [DOI:10.1016/S1001-7844(07)60025-X]
7. Kim J, Fazleabas A. Uterine receptivity and implantation: The regulation and action of insulin-like growth factor binding protein-1 (IGFBP-1), HOXA10 and forkhead transcription factor-1 (FOXO-1) in the baboon endometrium. Reprod Biol Endocrinol 2004; 2: 34. [DOI:10.1186/1477-7827-2-34]
8. Ding T, Song H, Wang X, Khatua A, Paria BC. Leukemia inhibitory factor ligand-receptor signaling is important for uterine receptivity and implantation in golden hamsters (Mesocricetus auratus). Reproduction 2008; 135: 41-53. [DOI:10.1530/REP-07-0013]
9. Meseguer M, Aplin JD, Caballero-Campo P, O'Connor JE, Martin JC, Remohi J, et al. Human endometrial mucin MUC1 is up-regulated by progesterone and down-regulated in vitro by the human blastocyst. Biol Reprod 2001; 64: 590-601. [DOI:10.1095/biolreprod64.2.590]
10. Dimitriadis E, White CA, Jones RL, Salamonsen LA. Cytokines, chemokines and growth factors in endometrium related to implantation. Hum Reprod Update 2005; 11: 613-630. [DOI:10.1093/humupd/dmi023]
11. DeLoia JA, Krasnow JS, Brekosky J, Babaknia A, Julian J, Carson DD. Regional specialization of the cell membrane-associated, polymorphic mucin (MUC1) in human uterine epithelia. Hum Reprod 1998; 13: 2902-2909. [DOI:10.1093/humrep/13.10.2902]
12. Kimber SJ. Leukaemia inhibitory factor in implantation and uterine biology. Reproduction 2005; 130: 131-145. [DOI:10.1530/rep.1.00304]
13. Damario MA, Lesnick TG, Lessey BA, et al. Endometrial markers of uterine receptivity utilizing the donor oocyte model. Hum Reprod 2001; 16: 1893-1899. [DOI:10.1093/humrep/16.9.1893]
14. Bartosch C, Lopes JM. "Human Endometrium Ultrastructure during the Implantation Window: A New Perspective of the Epithelium Cell Types." Reprod Sci 2011; 18: 525-539. [DOI:10.1177/1933719110392055]
15. Ly D, Nabil KA, Joelle S, Agarwal A. Evidence-Based Management of Infertile Couples with Repeated Implantation Failure Following IVF. Current Women's Health Reviews 2010; 6: 200-218. [DOI:10.2174/157340410792007073]
16. Sher G, Fisch JD. Effect of vaginal sildenafil citrate on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. Fertil Steril 2002; 78: 1073-1076. [DOI:10.1016/S0015-0282(02)03375-7]
17. Sher G, Fisch JD. Vaginal sildenafil citrate (Viagra): a preliminary report of a novel method to improve uterine artery blood flow and endometrial development in patients undergoing IVF. Hum Reprod 2000; 15: 806-809. [DOI:10.1093/humrep/15.4.806]
18. 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: 53-59. [DOI:10.1016/j.fertnstert.2006.05.064]
19. Goodman C, Jeyendran RS, Coulam CB. P53 tumor suppressor factor, plasminogen activator inhibitor, and vascular endothelial growth factor gene polymorphisms and recurrent implantation failure. Fertil Steril 2009; 92: 494-498. [DOI:10.1016/j.fertnstert.2008.07.022]
20. Di X, Gennings C, Bear H, Graham L, Sheth C, White K, Gewirtz D. Influence of the phosphodiesterase-5 inhibitor, sildenafil citrate, on sensitivity to chemotherapy in breast tumor cells. Breast Cancer Res Treat 2007; 124: 349-360. [DOI:10.1007/s10549-010-0765-7]
21. Pyriochou A, Zhou Z, Koika V, Petrou C, Cordopatis P, Sessa WC, Papapetropoulos A. The phosphodiesterase 5 inhibitor sildenafil citrate stimulates angiogenesis through a protein kinase G/MAPK pathway. J Cell Physiol 2007; 211: 197-204. [DOI:10.1002/jcp.20929]
22. Kelly SM, Sladkevicius P, Campbell S, Nargund G. Investigation of the infertile couple: a one-stop ultrasound-based approach. Hum Reprod 2001; 16: 2481-2484. [DOI:10.1093/humrep/16.12.2481]
23. Jerzak M, Kniotek M, Mrozek J. Sildenafil citrate citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage. Fertil Steril 2008; 90: 1848-1853. [DOI:10.1016/j.fertnstert.2007.08.043]
24. Takasaki A, Tamura H, Miwa I, Taketani T, Shimamura K, Sugino N. Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium. Fertil Steril 2010; 93: 1851-1858. [DOI:10.1016/j.fertnstert.2008.12.062]
25. Paulus WE, Strehler E, Zhang M, Jelinkova L, El-Danasouri I, Sterzik K. Benefit of vaginal sildenafil citrate citrate in assisted reproduction therapy. Fertil Steril 2002; 77: 846-847. [DOI:10.1016/S0015-0282(01)03272-1]
26. Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003; 18: 2337-2341. [DOI:10.1093/humrep/deg461]
27. Wang L, Qiao J, Li R, Zhen X, Liu Z. Role of endometrial blood flow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles. Reprod Biol Endocrinol 2010; 8: 1-7. [DOI:10.1186/1477-7827-8-122]
28. Fanchin R, Righini C, Ayoubi JM, Olivennes F, de Ziegler D, Frydman R. New look at endometrial echogenicity: objective computer-assisted measurements predict endometrial receptivity in in vitro fertilization-embryo transfer. Fertil Steril 2000; 74: 274-281. [DOI:10.1016/S0015-0282(00)00643-9]
29. Chen SL, Wu FR, Luo C, Chen X, Shi XY, Zheng HY, Ni YP. Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study. Reprod Biol Endocrinol 2010; 8: 30. [DOI:10.1186/1477-7827-8-30]
30. Pellicer A, Valbuena D, Cano F, Remohi J, Simon C. Lower implantation rates in high responders: evidence for an altered endocrine milieu during the preimplantation period. Fertil Steril 1996; 65: 1190-1195. [DOI:10.1016/S0015-0282(16)58337-X]
31. Macklon NS, Fauser BC. Impact of ovarian hyperstimulation on the luteal phase. J Reprod Fertil 2000; 55 (Suppl.): 101-108.

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