Effect of Sildenafil on Endometrial Thickness and Uterine Artery Blood Flow in Infertile Women: A Prospective Randomized Controlled Study.

Chandni  Singh; Pragya  Khugsal; Vandana  Rajput; Shubha  Pandey

doi:10.51168/sjhrafrica.v6i12.2360

Authors

Dr. Chandni Singh Consultant, Department of Obstetrics and Gynaecology, Vardaan hospital, motihari, Bihar
Dr. Pragya khugsal Assistant Professor, Department of obstetrics and gynaecology, Himalayan Institute of Medical Sciences, Dehradun
Dr. Vandana Rajput Consultant, Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences, Dehradun
Dr. Shubha Pandey HOD, Department of Obstetrics and Gynecology, Kamla Nehru Memorial Hospital, Prayagraj, Uttar Pradesh

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2360

Keywords:

endometrial, thickness, sildenafil, citrate, estradiol, valerate

Abstract

Background:

Infertility affects 10–15% of couples worldwide. Endometrial thickness and uterine blood flow are crucial determinants of implantation success. This study evaluated the effect of sildenafil citrate on endometrial thickness and uterine artery blood flow in infertile women undergoing ovulation induction.

Methods:

This prospective randomized controlled study was conducted at Kamla Nehru Memorial Hospital (KNMH), Prayagraj, India, over one year (January 2018–March 2019). Sixty-six women aged 20–35 years with primary or secondary infertility were randomized into two groups: Group A (estradiol valerate only, n=34) and Group B (estradiol valerate + sildenafil citrate, n=32). Endometrial thickness, pulsatility index (PI), endometrial pattern, and pregnancy rate were assessed.

Results:

The mean age of participants was comparable between groups (Group A: 27.3±3.4 years; Group B: 26.9±3.1 years). The majority had primary infertility (Group A: 61.8%; Group B: 65.6%). Post-treatment endometrial thickness on the day of hCG was significantly higher in Group B (9.28±1.1 mm) compared to Group A (8.60±0.81 mm; p=0.003).
Pulsatility index on the day of hCG significantly decreased in Group B (1.44±0.22) compared to Group A (1.60±0.16; p<0.001).
Multilayered endometrium was significantly higher in Group B (68.75%) vs Group A (47.06%; p=0.037).
Pregnancy rate was significantly higher in Group B (28.13%) compared to Group A (11.76%; p=0.047).

Conclusion:

Addition of sildenafil citrate significantly improves endometrial thickness, uterine artery blood flow, and pregnancy rates compared to estradiol valerate alone.

Recommendation:

Sildenafil citrate may be considered as an adjunct therapy in infertile women with a thin endometrium undergoing ovulation induction.

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