The Effect of Sildenafil on Embryo Development Literature review

The Effect of Sildenafil on Embryo Development - Literature review Example To increase the success rate of IVF, the clinical and laboratory procedures were enhanced in order to reduce the risk of side-effects on the part of patients (Gupta and Agarwa, 2010). Despite the effort to improve the use of IVF, Diedrich et al. (2007) revealed that successful pregnancy rates remain low. The common problems encountered with the use of the IVF procedure includes: (1) inadequate supply of nutrients and oxygen necessary to make the embryo implant itself in the endometrium lining (Forbes and Westwood, 2010; Raine-Fenning et al., 2004a; Kennedy, 1997); (2) lack of endometrial receptivity (Forbes and Westwood, 2010; Kennedy, 1997); (3) failed ovarian responses to the IVF protocols (Oudendijk et al., 2012; Tarlatzis et al., 2003); and (4) uterine blood flow abnormalities caused by poor angiogenesis or vasculogenesis (Satterfield et al., 2010; Huppertz et al., 2006). Due to the failure of the embryo implant itself in the endometrium lining, women can either experience a misc arriage, a recurrent miscarriage, implantation failure, or a recurrent implantation failure (Christiansen et al., 2006; Margalioth et al., 2006; Tomassetti et al., 2006). Based on the study of Achache and Revel (2006), approximately 2/3 of failed IVF is caused by the inability of the embryo implant itself in the endometrium lining. One of the pharmacological drugs that are being considered in treating problems related to the endometrium lining is the sildenafil citrate (Hattori and Tabata, 2006). Through the use of this particular drug, the presence of nitric oxide can will not only create a positive effect on the endometrium lining during the implantation stage but also help in preventing the presence of intrauterine adhesions during menstruation and maintain normal blood pressure during pregnancy (Nakatsuka et al., 2002; Sher et al., 2000; Norman and Cameron, 1996). Based on the study of Sher et al. (2000), the use of 25 mg of sildenafil citrate vaginal suppository for at least four (4) times each day for a period of one week prior to ovarian stimulation will not only increase the endometrium thickness by more than 8 mm but also improve the uterine blood flow. In a similar study, Paulus et al. (2002) examined the effects of 25 mg of sildenafil citrate vaginal suppository on ten (10) women with poor endometria l response to IVF. After administering the vaginal suppository for at least four (4) times each day, the authors noted a 9 mm increase in the endometrium thickness of nine (9) patients but no such improvements in the patients’ uterine blood flow (Paulus et al., 2002). Aside from having a trilaminar pattern during the ovulation period, Chanona et al. (2004) found that it is possible to increase the endometrium thickness up to more than 10 mm after administering 50 mg of sildenafil citrate vaginal suppository each day between the 9th to 12th day of menstruation cycle.