Comparative Evaluation of Clomiphene Citrate Alone and Clomiphene Citrate and Sildenafil Citrate for Treatment of Infertility and its Outcome

Abstract

OBJECTIVE: To compare the effect of clomiphene citrate alone and clomiphene and sildenafil citrate for infertility treatment and its outcome.

MATERIAL AND METHODS: This study was carried out in the Department of Obstetrics and Gynecology of GSVM MEDICAL COLLEGE, KANPUR from JANUARY 2016 to SEPTEMBER 2017. Total 80 infertile women were included in this study and randomly divided into 2 groups, study and control groups. Control group were given oral CLOMIPHENE CITRATE tablets (50 mg daily for 5 days) for ovulation induction. Women in study group were advised to take Sildenafil Citrate capsule, 25 mg qid, starting from day 1-14 of the cycle in addition to clomiphene citrate. Assessment of endometrial thickness, pattern and vascularity was done on day 1, 8 and 14 of the cycle. RESULTS:In our study, none of the demographic characteristics of the patients showed statistically significant difference. Both the groups were comparable in terms of demographic profile. On adding sildenafil citrate to clomiphene cycles, post-treatment, percentage of patients with ET ≥ 8 mm was increased from 45.2% to 76.2%.On comparing Mean ET before and after treatment with clomiphene and sildenafil citrate, mean ET in sildenafil treated patients was significantly increased from 7.15 ± 1.34 mm to 9.16 ± 1.98 mm (p<0.0001). Using unpaired t test, we found significant difference between the two groups, RA-RI and PI values decreased after treatment with sildenafil citrate (p<0.0001). After 3 cycles of induction, pregnancy rates were 18.4% in control group and 38.1% in study group.3 months follow up after conception showed 15 single IU pregnancy in study group while 6 single IU pregnancy in control group. CONCLUSION: As our study shows, use of Sildenafil Citrate is a good way to improve endometrial thickness and receptivity and thus pregnancy rates. Thus, we recommend its use in infertile patients.