A Comparison Between the Effect of Vaginal Sildenafil Versus Oral Estradiol Valerate on Ultrasound Parameters of Endometrial Receptivity and Follicular Growth in Iraqi Females Receiving Letrozole for Induction of Ovulation

Authors

  • Sundus Ali Dawood High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University, Baghdad, Iraq
  • Mufeda Ali Jwad High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University, Baghdad, Iraq
  • Huda Ali Hussaini College of Medicine, Al Nahrain University, Baghdad, Iraq

DOI:

https://doi.org/10.28969/IJEIR.v10.i1.r3

Keywords:

Estradiol valerate, Sildenafil citrate, Endometrial receptivity

Abstract

Endometrial thickness (ET) is one of the best predictors of implantation rate and pregnancy success rate because endometrial growth depends on hormones. Estrogen regulates the proliferative phase, endometrial proliferation induced by estrogen after menstruation is largely dependent on blood flow to the basal endometrium that produces progesterone receptors which are required for progesterone-regulated endometrial growth in the secretory process. To compare the effect of estradiol valerate vs. sildenafil citrate on endometrial receptivity and subsequent pregnancy outcome in unexplained infertility patients receiving letrozole for ovulation induction. Herein, 21 patients with unexplained infertility underwent ovulation induction by letrozole (2.5 mg). Patients were divided into 2 groups; group A (10 patients) were given sildenafil tablets vaginally (25 mg) four times daily and group B (11 patients) were treated with estradiol valerate tablet 2 mg/12 hours. Patients were evaluated by transvaginal ultrasonography (TVS) to determine endometrial thickness, pattern, size, and the number of the dominant follicles, serum assessment of Vascular Endothelial Growth Factor (VEGF) level at trigger day, and chemical pregnancy outcome 14 days later. Results showed that the endometrial thickness, patterns of the endometrium, VEGF, size of the dominant follicle at the trigger day, and pregnancy rates were not significantly different between the two groups. However, the difference in the number of the dominant follicles at trigger day was statistically significant which is more in the sildenafil treated group. The present study confirmed the findings of both Sildenafil and E2 valerate to boost endometrial receptivity and pregnancy rate.

Author Biographies

Sundus Ali Dawood, High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University, Baghdad, Iraq

  Dr. Sundus Ali Dawood     She received the M.B.CH.B. from the College of Medicine, Al-Mustansiriya University in 2005. She occupied the position of rotator house officer in Al-Yarmouk Teaching Hospital from 2006-2007. She worked in Baghdad during her permanency in obstetrics and gynecology 2008-2009. until the start of a residency program in 2009 at Baghdad Teaching Hospital and graduated as a specialist in Obstetrics and Gynecology in 2011 with an H.D of Obst. And Gyne. She worked as a specialist in General Hospital in Al-Anbar city from 2011-2017. From 2018-2020 graduated as a specialist in infertility with H.D from Al-Nahrain University, the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies. Currently, she is attending Al Nahrain University, the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies as a Ph.D. student.

Mufeda Ali Jwad, High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University, Baghdad, Iraq

Dr. Mufeda Ali Jwad     She received her MBChB. From the College of Medicine at the University of Baghdad in 1996. Her M.Sc. in Applied Embryology and her Ph.D. in Infertility and Clinical Reproduction were from the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University in 2007 and 2018 respectively. She worked as a rotator in the Baghdad health department from 1996-1999. She worked in Gyn. & Obs. in Alsamawa general hospital and Babylon hospital from 2000-2003. She worked at the Babylon University, College of Medicine, anatomy and embryology department from 2003-2004. She has been working as a specialist physician and a consultant clinic at the High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al Nahrain University from 2008-2015. Currently, she is an assistant professor and specialist in infertility and clinical reproduction. She is the head of the clinical reproductive physiology department from 2019 till now. She has more than 25 published articles in national and international journals.

Huda Ali Hussaini, College of Medicine, Al Nahrain University, Baghdad, Iraq

  Dr. Huda Ali Hussaini     She received the M.B.Ch.B: Babylon University, College of Medicine, in 2000. The diploma in Radiology from the University of Baghdad in 2007. She is a fellow of the Iraqi Board for Medical Specialization, Council of Radiology since 2008. Currently, she is an assistant professor. Al Nahrain University, College of Medicine, department of surgery (specialist radiologist). She is a Member of staff in the high Institute of infertility diagnosis and ARTS. Including the ultrasound department in the institute since 2018. She has Participations in a lot of annual meetings, medical conferences. Seminars, continuous learning, and thesis discussion. She is a member of the Iraqi medical association, the Iraqi Society of Radiologists and medical imaging, the Iraqi Journal of Embryos infertility researches, European Society for Hybrid, Molecular, and translation imaging. She published more than 15 articles and has supervised many students.

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Published

2020-12-14

How to Cite

1.
Dawood SA, Jwad MA, Hussaini HA. A Comparison Between the Effect of Vaginal Sildenafil Versus Oral Estradiol Valerate on Ultrasound Parameters of Endometrial Receptivity and Follicular Growth in Iraqi Females Receiving Letrozole for Induction of Ovulation. IJEIR [Internet]. 2020 Dec. 14 [cited 2024 Mar. 28];10(1):35-50. Available from: https://ijeir.net/index.php/ijeir/article/view/v10p03-ijeir-2020

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Section

Research Articles