Efficacy of sildenafil citrate in women with unexplained recurrent miscarriage preconceptional and during 1st trimester of pregnancy

Objective: To evaluate the effect of low dose of sildenafil citrate on females with history of unexplained recurrent miscarriage (RM) before and during 1st trimester of pregnancy.
Patients and Methods: 120 women divided into Group I: Includes 60 patients who received aspirin 75 mg/ day + folic acid 5 mg/ day orally; Group II: Includes 60 patients who received aspirin 75 mg/ day+ folic acid 5 mg/ day + sildenafil citrate 20 mg/day, orally. The treatment starts from day 1 and continues till the end of the cycle. If menstruation occurred, the treatment is repeated for another 5 cycles or pregnancy occurs. If pregnancy occurred, the treatment continues till 14 weeks of gestation.
Results: Pulsatile index (PI), resistance index (RI) was significantly lower in sildenafil treated women in comparison with sildenafil non treated women. Serum NO level, conception rate and number of cases passed 1st trimester were increased significantly in sildinafil treated group when compared to sildenafil non treated group.
Conclusion: Administration of low dose of sildenafil citrate (20mg/day) orally with mild tolerable side effects resulted high possibility of conception and better chance for patients with unexplained RM to maintain their pregnancies in the 1st trimester.