Comparison of sildenafil and isosorbide effects on embryo transfer outcome in patients with recurrent implantation failure

Abstract

Infertility is one of the families' social and economic problems that affects about 10-15% of couples. As the age of marriage increases in developing societies, the increase in infertility treatment costs imposes an additional burden on families. The present study aimed to compare the effect of sildenafil and isosorbide dinitrate on embryo transfer results in women with recurrent implant failure who were referred to the Al-Zahra Infertility Clinic. Materials and Methods: This clinical trial study was performed on 100 patients referred to the infertility center of Al-Zahra Hospital for one year from the date of approval. Patients who underwent IVF treatment protocols had frozen embryos and had at least two previous unsuccessful embryo transfer cycles were studied in two groups receiving vaginal sildenafil or isosorbide. Endometrial preparation was started with estradiol valerate tablets at 4 mg and increased to 6 mg per day after three days. Standard endometrial preparation was given with 6 mg of estradiol daily for all patients. In addition, one group of isosorbide dinitrate 10 mg vaginal tablets was continued from the day of estradiol initiation to one day before embryo transfer, and in the second group, sildenafil tablets were administered vaginally. Results: The mean age of the sildenafil group was 32.46±6.95 years, and the isosorbide group was 31.74±5.96 years. Endometrial thickness after the intervention was 9.12±1.81 mm in the sildenafil group and 8.89±1.25 mm in the isosorbide group. Endometrial thickness in the sildenafil group was significantly higher than in the isosorbide group (p=0.023). The rate of live birth or ongoing pregnancy in patients was 20%, of which 11 patients (22%) were in the sildenafil group, and nine patients (18%) were in the isosorbide group.