Effect of combining estradiol valerate with sildenafil in increasing the thickness of the endometrium in infertile women before intrauterine insemination: a randomized clinical trial

Authors

  • Faranak Jalilvand Department of Gynecology and Obstetrics, Ardabil University of Medical Science, Ardabil, Iran
  • Maryam Sadat-Razavi Department of Gynecology and Obstetrics, Ardabil University of Medical Science, Ardabil, Iran
  • Firouz Amani Department of Community Medicine, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
  • Nasrin Mirzaei Department of Gynecology and Obstetrics, Ardabil University of Medical Science, Ardabil, Iran

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20232559

Keywords:

Endometrial thickness, Infertility, Sildenafil, Estradiol valerate, Intrauterine insemination

Abstract

Background: Therapies available for thin endometrium are limited and are mostly performed experimentally which most of these treatments have a similar function and increase blood flow to the endometrium, causing it to thicken and develop. The aim of the study was to compare the effect of estradiol valerate in combination with sildenafil on endometrial thickness in infertile women before intrauterine insemination.

Methods: In this randomized clinical trial 100 infertile women referred to Reyhaneh Infertility Center in Ardabil were randomly divided into two groups. Patients' endometrial thickness was assessed by vaginal ultrasound before treatment and then on day 9 of the cycle. The intervention group received one tablet of estradiol valerate every 12 h from the ninth day of menstruation for 4 days and sildenafil as 25 mg orally daily from day 9 to 12, but in the control group, patients received placebo tablets orally in addition to estradiol.

Results: There was no statistically significant difference between the intervention and control groups before and after the intervention in term of endometrial thickness. The rate of increase in endometrial thickness was 1.35 mm in the intervention group and 1.37 mm in the control group, but the difference was not statistically significant.

Conclusions: Estradiol valerate alone or in combination with sildenafil resulted in a significant increase in endometrial thickness and increasing oral sildenafil supplementation with oral estradiol valerate had no significant effect on increasing endometrial thickness.

References

Gnainsky Y, Granot I, Aldo PB, Barash A, Or Y, Schechtman E, et al. Local injury of the endometrium induces an inflammatory response that promotes successful implantation. Fertil Steril. 2010;94(6):2030-6.

Raziel A, Schachter M, Strassburger D, Bern O, Ron-El R, Friedler S. Favorable influence of local injury to the endometrium in intracytoplasmic sperm injection patients with high-order implantation failure. Fertil Steril. 2007;87(1):198-201.

Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003;18(11):2337-41.

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(1):53-9.

Isaacs JD, Wells CS, Williams DB, Odem RR, Gast MJ, Strickler RC. Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil Steril. 1996;65(2):262-6.

Paulson RJ. Hormonal induction of endometrial receptivity. Fertil Steril. 2011;96(3):530-5.

Zhang X, Chen CH, Confino E, Barnes R, Milad M, Kazer RR. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005;83(2):336-40.

Gleicher N, Vidali A, Barad DH. Successful treatment of unresponsive thin endometrium. Fertil Steril. 2011;95(6):2123-7.

Gonen Y, Casper RF. Sonographic determination of a possible adverse effect of clomiphene citrate on endometrial growth. Hum Reprod. 1990;5(6):670-4.

Mangal S, Mehirishi S. To study and compare the effect of vaginal sildenafil and estradiol valerate on endometrial thickness, blood flow and pregnancy rates in infertile women undergoing intrauterine insemination. Int J Reprod Contracep Obstetr Gynecol. 2016;5(7):2274-8.

Fetih AN, Habib DM, Abdelaal II, Hussein M, Fetih GN, Othman ER. Adding sildenafil vaginal gel to clomiphene citrate in infertile women with prior clomiphene citrate failure due to thin endometrium: a prospective self-controlled clinical trial. Facts Views Vis Obgyn. 2017;9(1):21-7.

Yavangi M, Heidari-Soureshjani S, Sadeghian A, Artimani T. Comparison of Endometrial Thickness with Concomitant Administration of Sildenafil Citrate and Ethinyl Estradiol vs Ethinyl Estradiol Alone for Frozen Embryo Transfer. J Clin Diagn Res. 2019;13:5-8.

Benni JM, Patil PA. An overview on sildenafil and female infertility. Indian J Health Sci Biomed Res (KLEU). 2016;9(2):131.

Dehghani FR, 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. Iran J Reprod Med. 2013;11(2):151-8.

Scaglione F, Donde S, Hassan TA, Jannini EA. Phosphodiesterase Type 5 Inhibitors for the Treatment of Erectile Dysfunction: Pharmacology and Clinical Impact of the Sildenafil Citrate Orodispersible Tablet Formulation. Clin Ther. 2017;39(2):370-7.

Jerzak M, Kniotek M, Mrozek J, Górski A, Baranowski W. Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage. Fertil Steril. 2008;90(5):1848-53.

Dickey RP, Taylor SN, Lu PY, Sartor BM, Rye PH, Pyrzak R. Relationship of follicle numbers and estradiol levels to multiple implantation in 3,608 intrauterine insemination cycles. Fertil Steril. 2001;75(1):69-78.

Downloads

Published

2023-08-25

How to Cite

Jalilvand, F., Sadat-Razavi, M., Amani, F., & Mirzaei, N. (2023). Effect of combining estradiol valerate with sildenafil in increasing the thickness of the endometrium in infertile women before intrauterine insemination: a randomized clinical trial. International Journal of Basic & Clinical Pharmacology, 12(5), 646–649. https://doi.org/10.18203/2319-2003.ijbcp20232559

Issue

Section

Original Research Articles