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.
Highlights
Letrozole is just as effective for ovulation induction as clomiphene citrate in patients with unexplained infertility (Eskew, et al [1])
Twenty-one patients with primary or secondary infertility were included in the present study, all patients had normal HSG and all received letrozole as an ovulation induction drug and they all had no gynecological problem
Regarding the demographic parameters were shown in Table 1 and the basal hormonal profile level (FSH, LH, PRL, E2, and TSH) were shown in Table 2, the statistical analysis showed no significant differences (P>0.05) between the group who was treated with letrozole plus sildenafil and those who was treated with letrozole plus estradiol valerate
Summary
Letrozole is just as effective for ovulation induction as clomiphene citrate in patients with unexplained infertility (Eskew, et al [1]). It is an orally active inhibitor of aromatase enzyme with strong potential for induction of ovulation. Aromatase enzyme inhibition causes a reduction in estrogen levels believed to result in more follicle-stimulating hormone (FSH) production, resulting in follicular growth (Requena, et al [3]). Inhibitors of aromatase enzymes cause a local increase in ovarian androgens that increases follicular sensitivity to FSH and stimulates insulin-like growth factor-1 (IGF-I) (Usluogullari, et al [4]). Many studies recorded a strong positive association between a 7 mm
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Iraqi Journal of Embryos and Infertility Researches
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
