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The Effect of Vaginal Sildenafil on The Outcome of Assisted Reproductive Technology Cycles in Patients with Repeated Implantation Failures: A Randomized Placebo-Controlled Trial
BACKGROUND: The aim of this study was to investigate the effects of vaginal sildenafil on the outcome of patients with at least two unsuccessful in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) attempts. MATERIALS AND METHODS: In this randomized placebo-controlled trial study, a to...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Royan Institute
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875854/ https://www.ncbi.nlm.nih.gov/pubmed/31710189 http://dx.doi.org/10.22074/ijfs.2020.5681 |
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author | Moini, Ashraf Zafarani, Fatemeh Jahangiri, Nadia Sadatmahalleh, Shahideh Jahanian Sadeghi, Marya Chehrazi, Mohammad Ahmadi, Firoozeh |
author_facet | Moini, Ashraf Zafarani, Fatemeh Jahangiri, Nadia Sadatmahalleh, Shahideh Jahanian Sadeghi, Marya Chehrazi, Mohammad Ahmadi, Firoozeh |
author_sort | Moini, Ashraf |
collection | PubMed |
description | BACKGROUND: The aim of this study was to investigate the effects of vaginal sildenafil on the outcome of patients with at least two unsuccessful in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) attempts. MATERIALS AND METHODS: In this randomized placebo-controlled trial study, a total of 66 infertile women aged ≤38 years, with a history of normal ovarian reserve, two prior consecutive failed IVF/ICSI attempts, human chorionic gonadotropin (hCG) day endometrial thickness <7 mm in all prior IVF/ICSI cycles, normal endometrial appear- ance by either hysteroscopy, hysterosonography, or hysterosalpingography enrolled in this study. The conventional gonadotropin-releasing hormone (GnRH) protocol was used for ovarian stimulation. The patients were randomly divided into three groups: vaginal sildenafil (suppository-100 mg/daily), vaginal placebo/sildenafil (suppository-100 mg/daily), and vaginal placebo (suppository). Each patient underwent colour Doppler ultrasound on day 14 of their previous cycle to investigate any abnormalities in the uterus and adnexa. Endometrial thickness, echo pattern, uterine artery resistance, and pulsatility indices were recorded pre- and post-treatment. The primary outcome measures were implantation, chemical and clinical pregnancy rates. For data analysis, SPSS version 20 software was used. In all tests, the significance level was considered less than 0.05. RESULTS: There was no significant difference between three groups in endometrial thickness on the hCG injection day. The chemical pregnancy in women who received sildenafil (alone or in combination with placebo) showed a two-fold increase in comparison to the placebo group. This increase was clinically meaningful, but according to sample size, it was statistically non-significant. The results of our study showed that the implantation was higher in women who received placebo/sildenafil compared to the other groups. The abortion rate was not statistically significant among the groups. CONCLUSION: Vaginal sildenafil may conceivably improve chemical pregnancy rates in repeated IVF failure patients. Further randomized clinical trials using oral or vaginal sildenafil with higher sample size are recommended (Registra- tion number: NCT03192709). |
format | Online Article Text |
id | pubmed-6875854 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Royan Institute |
record_format | MEDLINE/PubMed |
spelling | pubmed-68758542020-01-01 The Effect of Vaginal Sildenafil on The Outcome of Assisted Reproductive Technology Cycles in Patients with Repeated Implantation Failures: A Randomized Placebo-Controlled Trial Moini, Ashraf Zafarani, Fatemeh Jahangiri, Nadia Sadatmahalleh, Shahideh Jahanian Sadeghi, Marya Chehrazi, Mohammad Ahmadi, Firoozeh Int J Fertil Steril Original Article BACKGROUND: The aim of this study was to investigate the effects of vaginal sildenafil on the outcome of patients with at least two unsuccessful in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) attempts. MATERIALS AND METHODS: In this randomized placebo-controlled trial study, a total of 66 infertile women aged ≤38 years, with a history of normal ovarian reserve, two prior consecutive failed IVF/ICSI attempts, human chorionic gonadotropin (hCG) day endometrial thickness <7 mm in all prior IVF/ICSI cycles, normal endometrial appear- ance by either hysteroscopy, hysterosonography, or hysterosalpingography enrolled in this study. The conventional gonadotropin-releasing hormone (GnRH) protocol was used for ovarian stimulation. The patients were randomly divided into three groups: vaginal sildenafil (suppository-100 mg/daily), vaginal placebo/sildenafil (suppository-100 mg/daily), and vaginal placebo (suppository). Each patient underwent colour Doppler ultrasound on day 14 of their previous cycle to investigate any abnormalities in the uterus and adnexa. Endometrial thickness, echo pattern, uterine artery resistance, and pulsatility indices were recorded pre- and post-treatment. The primary outcome measures were implantation, chemical and clinical pregnancy rates. For data analysis, SPSS version 20 software was used. In all tests, the significance level was considered less than 0.05. RESULTS: There was no significant difference between three groups in endometrial thickness on the hCG injection day. The chemical pregnancy in women who received sildenafil (alone or in combination with placebo) showed a two-fold increase in comparison to the placebo group. This increase was clinically meaningful, but according to sample size, it was statistically non-significant. The results of our study showed that the implantation was higher in women who received placebo/sildenafil compared to the other groups. The abortion rate was not statistically significant among the groups. CONCLUSION: Vaginal sildenafil may conceivably improve chemical pregnancy rates in repeated IVF failure patients. Further randomized clinical trials using oral or vaginal sildenafil with higher sample size are recommended (Registra- tion number: NCT03192709). Royan Institute 2020 2019-11-11 /pmc/articles/PMC6875854/ /pubmed/31710189 http://dx.doi.org/10.22074/ijfs.2020.5681 Text en The Cell Journal (Yakhteh) is an open access journal which means the articles are freely available online for any individual author to download and use the providing address. The journal is licensed under a Creative Commons Attribution-Non Commercial 3.0 Unported License which allows the author(s) to hold the copyright without restrictions that is permitting unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited. http://creativecommons.org/licenses/by/3/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Moini, Ashraf Zafarani, Fatemeh Jahangiri, Nadia Sadatmahalleh, Shahideh Jahanian Sadeghi, Marya Chehrazi, Mohammad Ahmadi, Firoozeh The Effect of Vaginal Sildenafil on The Outcome of Assisted Reproductive Technology Cycles in Patients with Repeated Implantation Failures: A Randomized Placebo-Controlled Trial |
title | The Effect of Vaginal Sildenafil on The Outcome of Assisted
Reproductive Technology Cycles in Patients with Repeated
Implantation Failures: A Randomized Placebo-Controlled
Trial |
title_full | The Effect of Vaginal Sildenafil on The Outcome of Assisted
Reproductive Technology Cycles in Patients with Repeated
Implantation Failures: A Randomized Placebo-Controlled
Trial |
title_fullStr | The Effect of Vaginal Sildenafil on The Outcome of Assisted
Reproductive Technology Cycles in Patients with Repeated
Implantation Failures: A Randomized Placebo-Controlled
Trial |
title_full_unstemmed | The Effect of Vaginal Sildenafil on The Outcome of Assisted
Reproductive Technology Cycles in Patients with Repeated
Implantation Failures: A Randomized Placebo-Controlled
Trial |
title_short | The Effect of Vaginal Sildenafil on The Outcome of Assisted
Reproductive Technology Cycles in Patients with Repeated
Implantation Failures: A Randomized Placebo-Controlled
Trial |
title_sort | effect of vaginal sildenafil on the outcome of assisted
reproductive technology cycles in patients with repeated
implantation failures: a randomized placebo-controlled
trial |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6875854/ https://www.ncbi.nlm.nih.gov/pubmed/31710189 http://dx.doi.org/10.22074/ijfs.2020.5681 |
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