An overview on sildenafil and female infertility

Abstract

Endometrial thickness (EM) is one of the strongest predictors of implantation rate and ongoing pregnancy success rate. The endometrial growth is dependent on the uterine blood flow and angiogenesis. Recently, some reports discussed the possible beneficial effects of sildenafil citrate on EM. Sildenafil citrate leads to smooth muscle relaxation and vasodilation. Because of these biological properties, it is a potential candidate for female infertility, especially in the management of thin endometrium, which leads to low implantation and pregnancy rates. An updated electronic search was performed through PUBMED, MEDLINE, and COCHRANE and focused on peer-reviewed, randomized controlled trials, and observational cohort or case-control studies for the role of sildenafil in thin endometrium. Systematic search through all the clinical studies showed favorable results. They documented the beneficial role of sildenafil citrate in the treatment of thin endometrium in failed in vitro fertilization-embryo transfer cycles, assisted intrauterine insemination cycles, or resistant endometrium, where it increased the uterine receptivity.