STUDY OF THE EFFECT OF SILDENAFIL CITRATE AND LETROZOLE ON ENDOMETRIAL THICKNESS IN INFERTILITY PATIENTS IN A TERTIARY CARE HOSPITAL IN EASTERN INDIA

Background: Sildenafil is responsible for vascular smooth muscle relaxation and increased blood flow to the endometrium. This results in better endometrial thickness and receptivity and improvement in implantation of the embryos. Objective: Evaluation of the efficacy of vaginal sildenafil on the endometrial thickness and pregnancy outcomes in letrozole induced ovulation induction cycles. Materials And Methods: 102 infertile women were included in this prospective study. The women were allocated to two groups – Group A and Group B. Letrozole was used to induce ovulation in all these 102 women. Vaginal sildenafil twice daily was added to women of Group B from Day-8 of menstrual cycle till the day of hCG trigger. All women underwent follicular monitoring on Day-12 of menstrual cycle. If the follicle size was not adequate, then a repeat follicle scan was done after 2 days. Injection urinary hCG 5,000 IU IM was given as trigger. A timed intercourse was advised. On Day-30, a urine β-hCG was done to identify a positive pregnancy. Result: The mean endometrial thickness on the day of hCG trigger in women of Group B, i.e women who received sildenafil was 9.8 mm compared to 8.4 mm in Group A , i.e women without sildenafil. Pregnancy rate in women who received sildenafil was 62.7% , compared to 49.01% in women who did not receive sildenafil. Conclusion: Use of vaginal sildenafil in women undergoing letrozole induced ovulation induction cycles helps in improving endometrial thickness and pregnancy rates .