Sufficient endometrial thickness is markedly essentialfor occurrence of successful implantation and pregnancy continuation.Adequate uterine blood flow is necessary for endometrial growth, and it is hormonal dependent.Clomiphene citrate is first drug of choice for ovulation induction in PCOS women.Clomiphene citrate has anti-estrogenic effect onendometrial development and leads to diminish endometrial blood flow.Sildenafil citrate is a specific type of phosphodiesterase inhibitor 5, improves the vasodilatation effects of nitric oxide (NO) on blood vessels and smooth muscle.Sildenafil citrate boosts estrogen-induced endometrial growth and can improve uterine blood flow.
Aime of the work: The current study aimed to evaluate efficacy of vaginal sildenafil citrate during ovulation induction with clomiphene in PCOS women as regards endometrial thicknessand pregnancy rate.
Patients and methods:Prospective case-control study was conducted on 80 PCOS patients attending infertility clinic at El Shatby University Hospital of Alexandria University.The patients were randomly divided into two groups. Sildenafil group (40patients) received 50mg clomiphene twice daily, and vaginal sildenafil 50mg twice daily. Control (40pt) received 50mg clomiphene alone.Transvaginalultrasound assessment of the endometrium was when one dominant follicle reached size more than 18mm in diameter. Recording the clinical pregnancy rate was done.