Background: Endometrium consists of a simple columnar epithelium, forming numerous tubular glands, supported by a thick vascular stromal. Both glands and stromal undergo extensive changes during the menstrual cycle. The endometrium is functionally subdivided into two layers
Aim: to assess the safety and efficacy of sildenafil on endometrium thickness, Number of mature follicle, Doppler indices of uterine artery and follow the effect on pregnancy outcome and rate of miscarriage.
Patient and Methods: Randomized trial included 300 women recruited from outpatient obstetrics and gynecology clinic in Al -Azhar university Hospital, Assuit branch divided on three groups; Group (I): 100 patients (letrzole with sildenafil citrate). Group (II): 100 patients (letrzole with Placebo). Group (Ⅲ): 100 patients (Clomiphene Citrate with Sildenafil Citrate).
Results: Our findings revealed that; In the current study, there was high significant difference between group Ⅰ & group Ⅱ and group Ⅱ &Ⅲ as regards endometrial thickness at HCG injection, all groups as regards number of follicle (18-22 mm) at HCG injection, Doppler indices at HCG injection (p 0.021in p1 , p 0.239 p2), Pregnancy rate (p < 0.001in p1, p < 0.285 in p2), abortion rate Ⅰ& group Ⅱ (p < 0.002 in p1 , p < 0.0280 in p2), all group in ovarian hyper stimulation syndrome rate (p < 0.001HS). No significant difference between all groups as regard of congenital fetal malformation (p 0.773 NS).
Conclusion: Sildenafil citrate with induction of ovulation was significantly effective in increasing pregnancy rate and decreasing abortion rate