Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2020 Nov;48(11):300060520969584.
doi: 10.1177/0300060520969584.

Effect of sildenafil citrate on treatment of infertility in women with a thin endometrium: a systematic review and meta-analysis

Xin Li  1 , Ting Luan  2 , Chun Zhao  1 , Mianqiu Zhang  1 , Li Dong  1 , Yan Su  1 , Xiufeng Ling  1
Affiliations
Meta-Analysis

Effect of sildenafil citrate on treatment of infertility in women with a thin endometrium: a systematic review and meta-analysis

Xin Li et al. J Int Med Res. 2020 Nov.

Abstract

Objective: Endometrial thickness is a prognostic factor for successful pregnancy. This meta-analysis aimed to examine the role of sildenafil citrate on infertile women with a thin endometrium.

Methods: Two investigators independently searched the literature on sildenafil citrate and infertile women with a thin endometrium from PubMed, EMBASE, and the Cochrane Controlled Trials Register Database from inception to January 2019.

Results: Nine studies involving 1452 patients were included for analysis in our study. We found that endometrial thickness in patients who received sildenafil citrate was significantly higher than that in the control group (placebo or no treatment) (weighted mean difference: 1.22; 95% confidence interval [CI]: 1.07-1.38). The radial artery resistance index was significantly lower (weighted mean difference: -0.12; 95% CI: -0.17 to -0.06), and the clinical pregnancy rate (risk ratio: 1.31; 95% CI: 1.11-1.53) and biochemical pregnancy rate (risk ratio: 1.45; 95% CI: 1.11-1.89) were significantly higher in the sildenafil citrate group compared with the control group.

Conclusion: Sildenafil citrate is effective in improving endometrial thickness, the clinical pregnancy rate, and the biochemical pregnancy rate in women who have a thin endometrium. This treatment is a potential therapeutic intervention for a thin endometrium.

Keywords: Sildenafil citrate; embryo implantation; infertile woman; pregnancy; radial artery resistance index; thin endometrium.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interest: The authors declare there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analysis flow diagram.
Figure 2.
Figure 2.
(a) Risk of bias summary. (b) Risk of bias graph.
Figure 3.
Figure 3.
Sensitivity of all of the outcomes of endometrial thickness. CI, confidence interval.
Figure 4.
Figure 4.
Results of a meta-analysis for the effects of endometrial thickness. WMD, weighted mean difference; CI, confidence interval.
Figure 5.
Figure 5.
Publication bias of endometrial thickness. WMD, weighted mean difference; se, standard deviation.
Figure 6.
Figure 6.
Results of a meta-analysis for the effects of the radial artery resistance index. WMD, weighted mean difference; CI, confidence interval.
Figure 7.
Figure 7.
Results of a meta-analysis for the effects of the clinical pregnancy rate. RR, risk ratio; CI, confidence interval.
Figure 8.
Figure 8.
Results of a meta-analysis for the effects of the biochemical pregnancy rate. RR, risk ratio; CI, confidence interval.
Figure 9.
Figure 9.
Results of a meta-analysis for the effects of the endometrial pattern. RR, risk ratio; CI, confidence interval.
See this image and copyright information in PMC

References

    1. Teh WT, McBain J, Rogers P. What is the contribution of embryo-endometrial asynchrony to implantation failure? J Assist Reprod Genet 2016; 33: 1419–1430. - PMC - PubMed
    1. Cakmak H, Taylor HS. Implantation failure: molecular mechanisms and clinical treatment. Hum Reprod Update 2011; 17: 242–253. - PMC - PubMed
    1. Yang W, Zhang T, Li Z, et al. Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst: A retrospective cohort study. Medicine (Baltimore) 2018; 97: e9577. - PMC - PubMed
    1. Liu KE, Hartman M, Hartman A. Management of thin endometrium in assisted reproduction: a clinical practice guideline from the Canadian Fertility and Andrology Society. Reprod Biomed Online 2019; 39: 49–62. - PubMed
    1. Zhao J, Zhang Q, Wang Y, et al. Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycle. Reprod Biomed Online 2014; 29: 291–298. - PubMed

Substances