A Comparative Study Between Clomiphene Citrate Therapy Alone And With Addition Of Estradiol Or Sildenafil In Patients With Unexplained Infertility

Abstract

In the past few years, much interest has been focused on the possible effect of estradiol in reversing the antiestrogenic effect of CC on the ! endometrium, thus increasing the pregnancy rate. Another approach is the use of vaginal sildenafil aiming at•promoting uterine vasodilatation and increasing the endometria(blood flow. Patients enrolled in this study were allocated to four groups; control gr up (group I) receiving no med!catioris, 2"d group (group II) receiving CC induction alone, . 3'd group (group Ill) receiving CC with e!flinyl estradiol, and 4111 group (group IV) receiving CC. with va naJ siidenafil, respectively. Assessment of endometrial thickness & pattern and uterine artery vascular indices was done at the titne of hCG administration using transvaginal sonography and Color Doppler. The deleterious .effects of . . • CC induction on endometrial. thickness & pattern and on uterine artery vascuiar indices were clear among the 2"d group: The use of thinyl estradiol or vaginal sildenafil with ovulation • induction by CC would improve the endometrial parameters which are believed to be one of the most important predictive factors of successful implantation and hence • better pregnancy rates.