Effectiveness of Estradiol and Sildenafil supplement therapy in IVF-ET patients with thin endometrium

Shin, So Young; Kim, Dae Wun; Shin, Jung Hwan; Hong, Seo Yoo; Park, Won Il; Cho, Byung Gu; Park, Joon Young; Hwang, Kyung Jin; Kwon, Hyuck Chan

Abstract

OBJECTIVE
The purpose of this study was to evaluate the effect of estradiol (E2) only/and sildenafil supplement on controlled ovarian hyperstimulation and pregnancy outcome in patients undergoing IVF-ET cycles.
METHODS
Total 104 cycles of IVF-ET patients were included in this study, which had been undergone controlled ovarian hyperstimulation (COH) with long protocol in Eulji infertility center and Ilsan Grace hospital between January 1999 and December 2000. Group 1 (COH only) consisted of 34 cycles, group 2 (COH+estradiol supplement) consisted of 35 cycles, and group 3 (COH+estradiol/sildenafil supplement) consisted of 35 cycles.
RESULTS
With E2 and/only Sildenafil supplement, improvement of the endometrial thickness (P<0.05) and clinical pregnancy rate (P<0.05) were obtained. There was no significant increase in pregnancy rate with sildenafil supplement compared to E2 supplement only (20.0% versus 25.7%). However, rather short duration of controlled ovarian hyperstimulation (13.3+/-1.7 days versus 11.7+/-1.7 days) was found in the group that received E2 and sildenafil supplementation. (P<0.1)
CONCLUSION
In patients with thin endometrium, the sildenafil supplement might lead to increase endometrial receptivity, and in consequence improvement of pregnancy rate. Sildenafil may augment the vasodilatory effect of nitric oxide by inhibition of cGMP hydrolysis, by improving ovarian perfusion, stimulates follicular development thus might shorten the duration of controlled ovarian hyperstimulation in IVT-ET cycles as we observed in our study.