Clinical outcomes of sildenafil application in patients of poor endometrial development

Objective:To determine whether sildenafil has an efect on pregnancy outcomes in patients with poor endometrial development.Mathods:This study included 472 infertility patients who underwent in viro fer tilization/intracytoplasmadc spemm injection and frozen-thawed embryo tr ansfer(IVF/ICSI-FET)and subsequently sufered from poor endo-metral dewelopment during homnone replacement cycle(HRC)from April 2017 to July 2019.The patients were divided into two groups:the sildenafl group(n=88)and the control group(n=384).We analyzed endometrial thicknuess and types on endometrial transformation day,as well as pregnancy outcomes after FET(biochemical pregnancy,clinical pregnancy,early abortion,late abortion,and live birth rates)between the two groups.Results:After adjusting for confounding factors,we found no significant differences in endometrial thicknesses and types on endometrial transfomation day between the sildenafil group and the control group(0.79±0.08 vs 0.81±0.09,P=0.144;79.76%vs83.87%,P=0.402).There were also no statistcally significant differences in biochemical pregnancy rate(75.0%vs76.8%,P=0.892),clinical pregnancy rate(59.09%vs 69.53%,P=0.087),early abortion rate(17.31%vs 14.61%,P=0.557),late abortion rate(3.85%vs 4.49%,P=0.859),or live birth rate(45.45%vs 55.47%,P=0.101)between the two groups.In subgroup analysis,the application of sildenafil was unable to improve endometrial thickness(group one:0.80±0.08 cm vs 0.82±0.08 cm;group two:0.78±0.08 cm vs 0.80±0.10 cm;group three:0.75±0.11 cm vs 0.77±0.08 cm,p>0.05)and type endometrium on transfomation day(group one:78.57%vs 86.78%;group two:80.65%vs 77.78%;group three:81.82%ws.83.78%,p>0.05).Moreover,sildenafil use was not closely associated with clinical pregnancy outcomes,clinical pregnancy rate,early abortion rate,late abortion rate,and live birth rate(p>0.05).Conclusions:Sildenafl did not benefit endometrial development and pregnancy outcomes in patients with poor endometr:ial development during the hormone replacement cycle.