Another underlying underdiagnosed condition that has recently been re-examined might be chronic endometritis that can be suspected with diagnostic hysteroscopy and confirmed with endometrial biopsy [59,60,61,62]. eCollection 2022 Jun. In this group, we found a significantly higher ChPR in women receiving Sildenafil. The effect of Sildenafil on endometrial characters in patients with infertility. Store sildenafil tablets at room temperature between 59F and 86F (15C and . With ED, you have. for that the aim of this study is to compare the effect of sildenafil-estrogen combination to estrogen alone on endometrium thickness in infertile women. Key search terms included the following: sildenafil (Mesh) AND infertility OR timed intercourse OR intrauterine insemination OR in-vitro fertilization OR assisted reproductive technology OR controlled ovarian stimulation OR fresh embryo transfer OR frozen embryo transfer. Other bias: in all studies, a power analysis was missing [12,19,37,38,39,40,41,42,43,44,45,46], and in one study [45], there was inconsistency between the population characteristic and inclusion criteria. Similarly, analyzing TI or IUI cycles, we found that the intervention was associated with a higher CPR and ChPR (low inconsistency, I2 = 0%). 2022 Jul 22;9:875810. doi: 10.3389/fvets.2022.875810. Compounded estradiol valerate or cypionate for injection also exists, and may be an alternative in times of shortage or more cost effective for those who must pay cash for their prescriptions. When the first patient arrives, the first envelope will be opened and the patient will be allocated according to the letter inside. In this group, a significant improvement was highlighted for Eth, CPR and ChPR. Please remove one or more studies before adding more. Fertil Steril. Licensee MDPI, Basel, Switzerland. Influence of endometrial thickness on pregnancy rates in modified natural cycle frozen-thawed embryo transfer. For PAH: Take this drug three times per day about 4-6 hours apart. A separate analysis was not significant. Ever since erectile dysfunction (ED) drugs were . Moreover, while there are several routes and duration of administration of E2, including per Os, transdermal, Intramuscular and vaginal, no compelling advantage for one protocol for endometrial preparation over another, with regard to pregnancy rates, has been established. Further studies are needed to reveal whether the way of Sildenafil administration has a significant effect on endometrial thickness and the pregnancy rate. Concerning administration route (vaginal vs. oral) and ETh, we found no significant effect of Sildenafil on endometrial thickness (MD 0.33, 95% CI 0.541.20, p = 0.45), but heterogeneity was high (I2 = 95%). Moreover, in our meta-analysis, the pregnancy rate resulted higher in Sildenafil treated women (p = 0.05), probably due to higher vascularization and, therefore, higher receptivity. Understanding endometrial angiogenesis mechanisms and the roles of angiogenic factors during ART treatments might provide new insights and clarify the effect of Sildenafil on the endometrium during different phases of the endometrial cycle. official website and that any information you provide is encrypted Conventional and modern markers of endometrial receptivity: A systematic review and meta-analysis. As the only study evaluating vaginal administration in this subgroup (TI/IUI) [38] compared Sildenafil to estrogen, while the other subgroup studies compared Sildenafil to no intervention, we excluded this study for this analysis. Madeira C.R., Tonin F.S., Fachi M.M., Borba H.H., Ferreira V.L., Leonart L.P., Bonetti A.F., Moritz R.P., Trindade A., Gonalves A.G., et al. Unable to load your collection due to an error, Unable to load your delegates due to an error. Based on these principles, randomized controlled trials investigated the efficacy of oral or vaginal Sildenafil administration in women undergoing infertility treatments. Sildenafil Tablets. Do not take Viagra while also taking Revatio. Balmaceda J.P., Ciuffardi I. Hysteroscopy and assisted reproductive technology. Concerning CPR, three papers reported this outcome [38,39,41], one analyzing IUI [38] and two TI [39,41]. Studies a U.S. FDA-regulated Drug Product: Studies a U.S. FDA-regulated Device Product: Product Manufactured in and Exported from the U.S.: endometrial line thickness [TimeFrame:9 days], positive pregnancy test [TimeFrame:14 days after triggering of ovulation], sub endometrial blood flow [TimeFrame:9 days]. Tehraninejad E.S., Khazei N., Ayati E., Movafegh A., Azimaraghi O. Even if only one study evaluated the oral administration of Sildenafil in these groups [42], vaginal administration seems to be more effective, but further studies are needed to confirm these results. Fahmy A.A., El Sokkary M., Sayed S. The value of oral sildenafil in the treatment of female infertility: A randomized clinical trial. ); ti.dpinu@inasirdna.ardnassela (A.A.); moc.liamg@onailgativ (A.V. Dreisler E., Kjer J.J. Ashermans syndrome: Current perspectives on diagnosis and management. Concerning ChPR, six papers reported this outcome [19,37,38,39,40,41], one analyzing IUI [38] and five TI [19,37,39,40,41]. Instead, all women evaluated in the frozen-ET groups underwent an endometrial preparation with an artificial cycle. A systematic review and meta-analysis. Nitric oxide (NO) relaxes vascular smooth muscle through a cGMP-mediated pathway and NO synthase isoforms have been identified in the uterus. In one of these three trials [45], one of the three randomized arms received a placebo from the from 1st2nd day until 2 days before hCG administration, then Sildenafil until OPU. Benkhalifa M, Joao F, Duval C, Montjean D, Bouricha M, Cabry R, Blanger MC, Bahri H, Miron P, Benkhalifa M. Int J Mol Sci. Dickey R.P., Taylor S.N., Lu P.Y., Sartor B.M., Rye P.H., Pyrzak R. Relationship of follicle numbers and estradiol levels to multiple implantation in 3608 intrauterine insemination cycles. Cozzolino M., Vitagliano A., Di Giovanni M.V., Lagan A.S., Vitale S.G., Blaganje M., Drusany Stari K., Borut K., Patrelli T.S., Noventa M. Ultrasound-guided embryo transfer: Summary of the evidence and new perspectives. Girling J.E., Rogers P.A. Selective data reporting: five studies were judged at high risk of selective data reporting due to the absence of the registered study protocol [37,38,39,40,41,42,43,44,46]. In fact, vaginal absorption occurs through the vaginal mucosa which is highly vascularized, and it does not depend on food intake and avoids hepatic metabolism. used letrozole [39]. This is a decision you and your doctor will make. One tablet every 12 hour from 2nd day of the cycle till the day of trigger of ovulation). We analyzed all outcomes according to the assisted reproductive technique used. Further RCTs with rigorous methodology are still mandatory. Finally, the remaining trial did not specify the type of LPS [46]. To prepare the endometrium, Group A : 40 women are given oral estradiol valerate tablets 2mg 6-8 hourly from the day 2-14 of the cycle to prepare the endometrium ChPR results were significantly higher with delayed start [37,38,39,40] (RR 1.65, 95% CI 1.242.20, I2 = 0%, p = 0.0006). 2022 Oct 24;23(21):12787. doi: 10.3390/ijms232112787. Contact Us: info@kamahealth.ca. 2022 Jun;14(2):155-161. doi: 10.52054/FVVO.14.2.026. Timing of intervention: during the monitored cycle for TI or IUI; during the course of controlled ovarian stimulation (COS) for IVF and fresh_ET and during the course of endometrial preparation for frozen_ET. Soc. 2004;31(2):99-102. Oron G., Hiersch L., Rona S., Prag-Rosenberg R., Sapir O., Tuttnauer-Hamburger M., Shufaro Y., Fisch B., Ben-Haroush A. Endometrial thickness of less than 7.5 mm is associated with obstetric complications in fresh IVF cycles: A retrospective cohort study. This increase was clinically meaningful, but according to sample size, it was statistically non-significant. Considering only trials that evaluated fresh-ET, in all except one trial (using oral Sildenafil, 50 mg [42]), Sildenafil was vaginally administered [45,46]. One other author (A.A.) reviewed the selection and data extraction process. Take it at the same time every day. Effect of vaginal sildenafil on the outcome of in vitro fertilization (IVF) after multiple IVF failures attributed to poor endometrial development. eCollection 2022. sharing sensitive information, make sure youre on a federal ); moc.liamg@ocnaibopac (G.C.). Sildenafil citrate (Viagra), a type 5-specific phosphodiesterase inhibitor, augments the vasodilatory effects of NO by preventing the degradation of cGMP. Publishers Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Katzorke N., Vilella F., Ruiz M., Krssel J.S., Simn C. Diagnosis of endometrial-factor infertility: Current approaches and new avenues for research. See Supplemental Figure S2a. Side Effects Warnings Drug Interactions Used For Sildenafil belongs to a group of medications called phosphodiesterase type 5 inhibitors. and G.A. You have reached the maximum number of saved studies (100). Drug: Sildenafil citrate. Effects of combined use of sildenafil citrate (Viagra) and 17-estradiol on ovine coronary and uterine hemodynamics Authors: Willie D Zoma Scott Baker Cincinnati Children's Hospital Medical. Sildenafil acts as a type 5-specific phosphodiesterase inhibitor hence augments the vasodilatory effects of nitric oxide by preventing the degradation of cGMP. Regarding the non-improvement of Eth in women undergoing ART treated with Sildenafil, different explanations can be provided for patients undergoing fresh-ET and for patients undergoing frozen-ET. Kasius A., Smit J.G., Torrance H.L., Eijkemans M.J., Mol B.W., Opmeer B.C., Broekmans F.J. Endometrial thickness and pregnancy rates after IVF: A systematic review and meta-analysis. Mahajan N. Endometrial receptivity array: Clinical application. FOIA single dose orally from the 2nd day of the cycle for 5 days with oral estradiol valerate (Cyclo-Progynova 2mg, white tablets, BAYER Schering Pharma), one tablet every 12 hour from 2nd day of the cycle + sildenafil (silden 25, E.I.P.I.CO.) After viagra do you stay hard - General references fenichel gm pediatric neurology a signs and symptoms indicate cardiovascular compromise. Viagra comes as an oral tablet that contains the active drug sildenafil. When compared to estradiol alone (which. Why Should I Register and Submit Results? In approximately of children are caused by . The timing of administration was from the 1st2nd day until an ovulation trigger or oocyte retrieval all trials [42,45,46]. To prepare the endometrium, Group A : 40 women are given oral estradiol valerate tablets 2mg 6-8 hourly from the day 2-14 of the cycle to prepare the endometrium See Supplemental Figure S1a. The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. During the last decades, several strategies (including hormonal and non-hormonal adjuvants) have been tested with the purpose of increasing ETh in women undergoing infertility treatments, with conflicting results [7,8,9,10,11,12,13,14,15,16,17]. One of the adjuvants that showed potential beneficial effects on endometrial thickening in women undergoing infertility treatments is sildenafil citrate, a 5-phosphodiesterase inhibitor widely used for male erectile dysfunction [18]. Uses. Women undergoing fresh or frozen embryo transfer who received Sildenafil showed no significant advantages regarding ETh and CPR in comparison to controls. The remaining studies were judged at low risk [12,19]. 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. independently screened titles and abstracts of studies obtained by the search strategy. official website and that any information you provide is encrypted For these reasons, many efforts have been made in order to obtain a thicker endometrium with different strategies involving hormonal approaches (estradiol administration adjustment, hCG administration during the follicular phase, GnRH agonist administration during the luteal phase), the intrauterine infusion of growth factors such as the granulocyte colony-stimulating factor and platelet-rich plasma and the usage of factors that act on endometrium vascularity [66]. Recent advances in endometrial angiogenesis research. Endometrial growth is thought to depend on uterine artery blood flow and the importance of endometrial development on in-vitro fertilization (IVF) outcome has been previously reported. Kansouh A.M., El-Naggar M.A. ); ti.dpinu@inisorbma.odiug (G.A. (b) Forest plot of comparison: clinical pregnancy rate (CPR) according to group allocationintervention (Sildenafil) versus control in intrauterine insemination and timed intercourse cycles. This leads to an increase in smooth muscle relaxation and vasodilation. A subgroup analysis for the evaluation of the way of Sildenafil administration was possible only for the IVF Fresh-ET/Frozen-ET groups. Before Liu X., Qu P., Bai H., Shi W., Shi J. Endometrial thickness as a predictor of ectopic pregnancy in 1125 in vitro fertilization-embryo transfer cycles: A matched case-control study. 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. ART in Europe, 2017: Results generated from European registries by ESHRE. Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03301233, The new site is coming soon - go to the modernized. Contracept. However, despite different approaches that might be available, a lack of solid evidence in the published literature limits their clinical applicability. A manual search of reference lists of retrieved studies and available review articles was also performed to avoid missing relevant publications. The site is secure. The only study analyzing IUI did not report this outcome [38]. For treatment of erectile dysfunction: For oral dosage form (tablets): It helps to achieve and keep an erection sufficient for sexual activity. The use of a combination of pentoxifylline and tocopherol in women with a thin endometrium undergoing assisted conception therapiesA report of 20 cases. This effect is widely used in males for erectile dysfunction [68]. Villanueva-Garca D, Mota-Rojas D, Hernndez-Gonzlez R, Snchez-Aparicio P, Alonso-Spilsbury M, Trujillo-Ortega ME, Necoechea RR, Nava-Ocampo AA. Women who have any tubal factor that relates to infertility (e.g., tubal adhesion or previous ectopic pregnancy). Concerning luteal phase support (LPS), in one trial, a daily intramuscular injection of progesterone (150 mg) was administered [42]; instead, in another study, LPS was indistinctly supported through the daily intramuscular or vaginal administration of progesterone [45]. However, considering women undergoing fresh- or frozen-ET, only the ChPR improvement was reported and not the CPR. Finally, 12 manuscripts were included in the meta-analysis (see Figure 1: Prisma Flow Diagram). Random sequence generation: four studies [12,19,43,45] were judged at low risk of bias because an adequate method of random sequence generation was reported. sharing sensitive information, make sure youre on a federal This meta-analysis of randomized controlled trials (RCTs) evaluates the effects of Sildenafil administration during infertility treatments compared with a control group in infertile women. See Supplemental Figure S2b. Figure S2: a Forest plot of comparison, subgroup analysis according to administration route: endometrial thickness (ETh) according to group allocationintervention (Sildenafil) versus control in IVF fresh and frozen embryo transfer. Concerning CPR, four papers reported this outcome [42,44,45,46], three of them reported data from IVF fresh-ET (IVF group) [42,45,46] and only one from frozen-ET (FET group) [44], with a total of 293 participants. Warnings Qublan H., Amarin Z., Al-Qudah M., Diab F., Nawasreh M., Malkawi S., Balawneh M. Luteal phase support with GnRH-a improves implantation and pregnancy rates in IVF cycles with endometrium of < or =7 mm on day of egg retrieval. Regarding the improvement of Eth in women undergoing MAR treated with Sildenafil, it is known that this molecule improves artery blood flow through the prevention of cGMP breakdown [18]. Significantly higher cumulative clinical pregnancy rate (3 intrauterine insemination cycles). Viagra (sildenafil) is used to treat erectile dysfunction, the inability to get or keep an erection for satisfactory sexual activity in men. Accessibility Concerning the timing of Sildenafil administration (at the beginning of stimulation versus delayed start) and ChPR, four papers reported data about delayed start [37,38,39,40] and two papers about the beginning of stimulation [19,41]. For most patients, the recommended dose is 50 mg taken, as needed, approximately 1 hour before sexual activity. Only one study [19] described the luteal phase support with oral progesterone from the day of ovulation (Dufaston 10 mg twice daily). Mahajan N., Sharma S. The endometrium in assisted reproductive technology: How thin is thin? For the estimation of selective data reporting, we evaluated study protocols, when available. Concerning studies analyzing FET, in all trials [12,43,44], Sildenafil was vaginally administered. [T]hey can get erections at other times, but they get anxious, particularly in new situations, new relationships, or if they're . The PI was decreased after 7 days of sildenafil (indicating increased blood flow) and returned to baseline following treatment with placebo. Thus, the aim of this present systematic review and meta-analysis was to summarize the current evidence on the effectiveness of Sildenafil administration for improving ETh and the success of ARTs and MAR procedures. The only trail that considered oral administration in women undergoing the described ART techniques [42] showed a significant improvement in ETh but not in the pregnancy rate. Of these, 528 records were excluded after title/abstract screening (not relevant to the review). Considering the number of included studies, we performed analyses firstly together and then separately by TI/IUI (TI/IUI group) [19,37,38,39,40,41] and IVF fresh-ET and frozen-ET (IVF fresh-ET/frozen-ET group) [12,42,43,44,45,46]. Due to its supposed action of favoring implantation both through the increase in endometrial thickness [19] and through the immune action [20], this type of add-therapy has been studied on different types of infertile women, both those with a thin endometrium and those without an apparent endometrial problem. One study [46] enrolled infertile women with at least two previous failed FIVET cycles. Women receiving Sildenafil therapy showed higher ETh in comparison to controls, MD 1.39 (95% CI 0.502.28, p = 0.002), but with high statistical heterogeneity (I2 = 86%). J. Gynaecol. Mangal S. et Mahirishi S. [38] used both clomiphene citrate and gonadotropins for follicle recruitment and instead Mohamed T.Y. The separate analysis of TI and IUI showed no statistical significance. The combination of sildenafil and oestradiol valerate improved blood flow and endometrial thickness in all patients. Vaughan D.A., Harrity C., Sills E.S., Mocanu E.V. Despite these second-line investigations, many times the underlying cause cannot be identified. Considering only TI, the RR was 1.66 (95% CI 1.262.17, p = 0.0002), but no significant advantages were found in the paper reporting data from IUI cycles. The .gov means its official. performed the statistical analysis; L.M., M.N., A.A. and L.B. Leukes VN, Malherbe ST, Hiemstra A, Kotze LA, Roos K, Keyser A, De Swardt D, Gutschmidt A, Walzl G, du Plessis N. Front Immunol. Zolghadri J., Haghbin H., Dadras N., Behdin S. Vagifem is superior to vaginal Premarin in induction of endometrial thickness in the frozen-thawed cycle patients with refractory endometria: A randomized clinical trial. Serum estradiol:oocyte ratio as a predictor of reproductive outcome: An analysis of data from >9000 IVF cycles in the Republic of Ireland. All analyses were performed with the random-effects model (by DerSimonian and Laird), with an intention-to-treat approach. Oral sildenafil for treatment of female infertility among pco patients: Randomized comparative study. Gynecol. Women who have any congenital uterine anomaly (e.g., unicornuate uterus or infantile uterus) or acquired deformities of the uterine cavity that interfere with embryo implantation (as Asherman Syndrome). We searched for published and unpublished studies from the aforementioned electronic databases. Received 2021 Aug 10; Accepted 2021 Sep 20. This aspect may explain the non-significant results in endometrium thickness obtained in women undergoing transfer after treatments that required higher estradiol levels. An official website of the United States government. Authors judgements were expressed as low risk, high risk, or unclear risk of bias. Off. All six studies assessed endometrial thickness on the hCG trigger day or before progesterone administration starting. Blinding of participants and personnel: two studies were at low risk of bias [42,45]; all other trials were at unclear risk because no information was reported [12,19,37,38,39,40,41,43,44,46]. The dynamics of action of the estrogens administered in the artificial cycles of endometrial preparation on the endometrium are not fully known. Medically Reviewed by Nazia Q Bandukwala, DO on July 09, 2021. Chanona J., Garcia M., Ruvalcaba L., Bermudez A., Muniz M., Beltran M., Cuneo S. The Mexican experience in the use of vaginal sildenafil in patients with poor endometrial response. Women undergoing ovulation induction who received Sildenafil showed higher ETh and a higher CPR in comparison to controls. To compare the effect of estradiol valerate vs. sildenafil citrate on endometrial receptivity and subsequent pregnancy outcome in unexplained infertility patients receiving letrozole for. This is a systematic review and meta-analysis of RCTs evaluating the effectiveness of add-therapy with Sildenafil in MAR and ARTs procedures. https://creativecommons.org/licenses/by/4.0/, https://www.mdpi.com/article/10.3390/jcm10194346/s1, - CC 100 mg/day starting from day 2 of the cycle for 5 days, Significant improvement of endometrial thickness and pattern in Sildenafil treated women, - letrozole 5 mg from 3rd to 7th day of the cycle, - clomiphene citrate 150 mg from 3rd to 7th day of the cycle. A decade ago, Sher and Fisch studied the effect of vaginal sildenafil on the endometrial thickness of infertile patients with poor endometrial development, who underwent IVF treatment. Concerning the timing of Sildenafil administration (at the beginning of stimulation versus delayed start) and ETh, three papers reported data about delayed start [37,39,40] and two papers about the beginning of stimulation [19,41]. Inclusion in an NLM database does not imply endorsement of, or agreement with, Two studies [38,40] assessed the pregnancy rate on cumulative cycles (three). Fed. Women who have contraindication for estrogen treatment (e.g., history of stroke, DVT and Benign liver disease). In all trials [42,45] except one (in which data were not specified [46]), embryo transfer was performed after twothree days of an in vitro culture. . Before Vitagliano A., Saccardi C., Litta P.S., Noventa M. Chronic endometritis: Really so relevant in repeated IVF failure? However, sildenafil tablets may be taken anywhere from 30 minutes to 4 hours before sexual activity Based on effectiveness and toleration, may increase to a maximum of 100 mg or decrease to 25 mg Maximum recommended dosing frequency is once per day () After the removal of 100 duplicate records, 556 citations remained. Tablet Powder for Suspension Before Using In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. Two studies were placebo-controlled [19,37]; in one study, the control group received co-intervention with estradiol [38], and the remaining were treatment versus no treatment [39,40,41]. Jerzak M., Kniotek M., Mrozek J., Gorski A., Baranowski W. Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage. In summary, a biological explanation of the apparently different efficacies of Sildenafil among women undergoing TI and IUI compared to women undergoing IVF and fresh or frozen-ET might lie on the different levels of estrogen that are achieved during the different types of treatments [74,75]. According to several studies, one of the major limiting factors for the success of ART might be represented by impaired endometrial receptivity (ER) [2]. Women undergoing controlled ovarian stimulation achieve an increase in peak serum estradiol levels up to 1012 times higher [73]. A randomized clinical trial of sildenafil plus clomiphene citrate to improve the success rate of ovulation induction in patients with unexplained infertility. ), 2Department of Molecular Medicine-Biological Chemistry, University of Padova, 35131 Padova, Italy; ti.dpinu@nidrob.anaicul, 3Department of Surgical, Microsurgical and Medical Sciences, Gynecologic and Obstetric Clinic, University of Sassari, 07100 Sassari, Italy; moc.liamg@elossedocsecnarf (F.D. This route of administration could ensure a higher endometrial concentration of sildenafil. Endocrinol. reviewed the manuscript. Population: infertile women undergoing MAR and ARTs procedures, including TI, IUI and IVF with fresh fresh-ET or Frozen-ET. Regarding the pregnancy rate, one study [12] evaluated ChPR, whereas the other three [42,45,46] assessed CPR, and another one [44] considered both ChPR and CPR. These findings were reproduced in an ensuing gonadotrophin-stimulated cycle. Two studies only considered infertile women with a persistently thin endometrium, defined as endometrium thickness <7mm on the 8th day of the cycle or on the day of ovulation trigger [38,41]. As natural killer cells release cytokines that are involved in embryo implantation failure through nitric oxide action, it may be beneficial to limit Sildenafil administration only when spiral arteries have already formed to avoid a high concentration of nitric oxide [72]. In particular, a subgroup analysis evidenced that the delayed start of Sildenafil administration might significantly increase the chances of obtaining a thicker endometrium and pregnancy. Another study [45] considered women with at least two previous failed FIVET cycles and also a persistent thin endometrium defined as endometrial thickness < 7 mm measured the day of ovulation triggering. J Sex Med. Neither sildenafil nor vaginal estradiol improves endometrial thickness in women with thin endometria after taking oral estradiol in graduating dosages. However, outcomes were calculated by pooling the results of a small number of studies and a small number of patients. We found a significant advantage related to Sildenafil treatment with a total RR of 1.79 (95% CI 1.092.95, p = 0.02) with no heterogeneity (I2 = 0%). One study [46] did not report random sequence generation, and in three studies [12,43,45], an adequate method of random sequence generation was used, and the randomizing methods of last two studies [42,44] were judged at high risk of bias. Three RCTs reported data about COS with fresh embryo transfer with 198 patients included [42,45,46], and three RCTs reported data about FET with 195 patients included [12,43,44]. This study had no funding and no financial support. Although sometimes the endometrium might be receptive even if a thinner value is used as a cut-off [49], an association has been demonstrated between low endometrial thickness, ART failure and adverse pregnancy outcomes related to an abnormal placentation such as hypertension, preeclampsia, intrauterine growth defects [63,64,65]. Gambino L.S., Wreford N.G., Bertram J.F., Dockery P., Lederman F., Rogers P.A. Endocrinol. Gynaecol. Moher D., Liberati A., Tetzlaff J., Altman D.G. See Figure 3c. 7 The vasodilating action of sildenafil affects both the arteries and the veins, so the most . The same authors have independently extracted data from the studies. Obstet. If you are taking Revatio do not take Viagra unless directed by your physician. Moreover, a certain heterogeneity across studies was present in terms of inclusion criteria (exclusion of uterine pathologies), Sildenafil therapy (way, dose and timing of administration) and population characteristics. Six RCTs have been included in the IVF Fresh-ET/Frozen-ET section (Table 2) with a total of 393 participants. Careers. Administer sildenafil tablet doses 4 to 6 hours apart. Toll free: 1-888-533-9842. Sildenafil (Viagra). Liu Y., Ye X.Y., Chan C. The association between endometrial thickness and pregnancy outcome in gonadotropin-stimulated intrauterine insemination cycles. eCollection 2022. Forman E.J., Hong K.H., Ferry K.M., Tao X., Taylor D., Levy B., Treff N.R., Scott R.T., Jr. (c) Forest plot of comparison: chemical pregnancy rate (ChPR) according to group allocationintervention (Sildenafil) versus control in IVF fresh and frozen embryo transfer. (b) Forest plot of comparison: clinical pregnancy rate (CPR) according to group allocationintervention (Sildenafil) versus control in IVF fresh and frozen embryo transfer. Study record managers: refer to the Data Element Definitions if submitting registration or results information. As a library, NLM provides access to scientific literature. In frozen-ET, the supplementation of Sildenafil might be useful to reach the maximum effect on endometrial vascularization, while maybe this is not possible in women undergoing fresh-ET who have higher levels of estrogens. Youre on a federal ) ; ti.dpinu @ inasirdna.ardnassela ( A.A. ) ; moc.liamg @ (... Infertility ( e.g., tubal adhesion or previous ectopic pregnancy ) remaining trial not! Evidence in the frozen-ET groups underwent an endometrial preparation on the outcome of in vitro (... Ovulation ) drug sildenafil arrives, the recommended dose is 50 mg taken as! Of sildenafil-estrogen combination to estrogen alone on endometrium thickness in women undergoing controlled ovarian stimulation achieve an in! ) and returned to baseline following treatment with placebo in women receiving sildenafil Necoechea! 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