Sildenafil causes vasodilatation by relaxing smooth muscles of blood vessels, enhances endometrial development. Improving endometrial thickness is one of the cornerstones in the management of infertility

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

Materials and Methods: 50 infertile women with thin endometrium were randomly divided into two groups. Group A comprised of 25 women in whom clomiphene citrate 50 mg daily from D2 to D6  along with estradiol valerate 2 mg thrice daily from D2 and  Group B  of 25 women in whom 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 were given. Trans-vaginal ultrasound was done on alternate days from D8 of cycle for monitoring of follicular development and endometrial characters.HCG trigger was given once the dominant follicle reached >18 mm. Total three cycles of ovulation were studied.

Results: Monitoring of endometrial characters in all the ovulation induced cycles showed significant improvement in Group B. In Group B Mean endometrial thickness was 10.2±1.6mm whereas it is 8.53±1.4 mm in Group A; trilaminar pattern was 93.54% in group B compared to 40.29% in Group A; Zone 4 endometrium was 79.03% in Group B compared to 26.86% in Group A; clinical pregnancy rate per cycle was 20.96% in Group B compared to 13.45% in Group A.

Conclusion: Addition of vaginal Sildenafil to estradiol valerate has significant effect in improving endometrial characters and clinical pregnancy rates in ovulation induction cycles.

Keywords: Sildenafil; Estradiol; Endometrium.

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Dr Alla Satyanarayana Reddy

Professor in OBG, Vinayaka Mission`s Medical College & Hospital, Karaikal, Pondicherry, India. 609609