الفهرس 
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Abstract
he etiology of infertility is diverse. Despite the improvement in ovarian stimulation protocols and techniques, results of in vitro fertilization (IVF) have unfortunately reached a plateau. Diverse and unexplained factors affecting implantation rates have become a major limiting factor. Therefore, more attention needs to be focused on implantation and endometrial receptivity.
Good embryo quality, appropriately timed and arranged endometrial receptivity, and efficient crosstalk between the embryo and the receptive endometrium are required for successful implantation. Impairment of any one of these factors may result in implantation failure.
To improve poor endometrial response, several regimens have been put forward, including treatment with estrogens and low dose aspirin. Sildenafil citrate improves the uterine artery blood flow and the endometrial thickness in women with a prior failed assisted reproductive cycle due to poor endometrial response. Sildenafil citrate can be used orally or by vaginal to improve endometrial receptivity.
The aim of the study is to evaluate the efficacy of the orally administered sildenafil citrate on the endometrial thickness and pregnancy rate in infertility patients undergoing IVF.
• The study included eighty patients who were randomized into two groups. group A included fourty patients who were given sildenafil citrate 25mg from 6th day to day of HMG injection of the cycle four times per day orally. group B included fourty patients who were given placebo tablets from cycle day 6 till day of HMG injection four times /day orally. Transvaginal U/S was done to detect endometrial thickness and number of follicles on day 6 and day of HMG injection for comparison.
• Serum B-HCG was done to detect pregnancy occurrence.
Results:
• Endometrial thickness in both groups was statistically insignificant between two groups when measured in day 6 with p-value 0.070.
• Endometrial thickness on day of HMG injection measured and founded that it was higher in group A(Sildenafil Group) than group B(Placebo Group) and it was statistically significant difference between two groups with p-value <0.001.
• Percentage of change in endometrial thickness was statistically significant between two groups with p-value <0.0001.
• Biochemical pregnancy rate in both study groups was founded to be higher in group A (Sildenafil Group) than group B (Placebo Group) and was statistically significant between both groups with p-value 0.040