Dehghani Firouzabadi Razieh, Davar Robab, Hojjat Farzaneh, Mahdavi Mohamad
Department of Obstetrics and Gynecology, Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Shahid Beheshti Taft Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Iran J Reprod Med. 2013 Feb;11(2):151-8.
Sildenafil citrate may increase endometrial thickness and affect the outcome of frozen-thawed embryo transfer cycles.
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.
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.
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.
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.
枸橼酸西地那非可能会增加子宫内膜厚度并影响冻融胚胎移植周期的结局。
本研究旨在评估枸橼酸西地那非对超声检查下子宫内膜厚度及形态的影响，并调查黄体酮给药当天的雌激素水平、冻融胚胎移植周期中的着床率及化学妊娠率。
本随机对照试验针对80例既往子宫内膜反应差且有冷冻胚胎的患者开展。40例患者采用月经周期逐步递增法给予雌二醇以准备子宫内膜，另外40例患者除上述治疗方案外，从周期第一天至开始使用黄体酮当天，每天服用枸橼酸西地那非片（50毫克）。在胚胎移植前48 - 72小时停用。
枸橼酸西地那非组的子宫内膜厚度显著更高（p<0.0001），枸橼酸西地那非组子宫内膜的三线型显著更高（p<0.0001），而两组子宫内膜的中间型无显著差异。对照组子宫内膜的回声型显著更高（p<0.0001）。最后，枸橼酸西地那非组的着床率和化学妊娠率更高，但无显著差异。
如我们的研究所示，口服枸橼酸西地那非是改善子宫内膜容受性的一种好方法。我们建议对于既往因子宫内膜厚度不佳导致辅助生殖技术周期失败的患者常规口服枸橼酸西地那非。
