Comparison of sildenafil and isorbid effects on embery transfer outcome in patients with recurrent implantation failure

1. Evaluation of implantation ،endometrial thickness and pregnancy in women with recurrent implant failure

The trial has two intervention groups, double-blind, randomized, phase ٢ on 90 patients. Chi-square test will be used to compare clinical fertility and statistical analysis will be performed using SPSS.26 software.

IVF Clinic of Tabriz Al-Zahra Hospital Endometrial preparation begins with estradiol valerate tablets. In first group Simultaneously with estradiol،sildenafil 50 mg vaginally and in the second group isosorbide dinitrate 10 mg with estradiol is administered vaginally. After embryo transfer luteal phase support is provided with progesterone injections.The facilitator will be aware of the study groups, and the researcher, data collector, and data analyst will be blinded to the study groups.

Patients with a history of infertility and twice implantation failure will be included in the study with consent Exclusion criteria 1. Treatment with antihypertensive drugs 2. Myoma, adenomyosis, congenital malformation of the uterus, endometriosis 3. History of cardiovascular or kidney or liver disease or the use of nonsteroidal anti-inflammatory drugs and any chronic disease 3. Reluctance to participate in the study

Endometrial preparation begins with estradiol valerate tablets at a dose of 4 mg and increases to 6 mg per day after 3 days. In the first group, in addition to standard treatment, isosorbide dinitrate 10 mg vaginal tablets (group 1) at the same time as estradiol It is started and continued for one day before embryo transfer. In the other group (group II), sildenafil 50 mg tablets daily are prescribed from the day of estradiol onset until one day before embryo transfer.

Endometrial thickness examination, BHCG titer examination pregnancy

In this study, there will be two intervention groups. Assignment of patients to study groups after their arrival will be done using closed letter envelopes with numbers 1 to the maximum sample size on the envelopes and AB groups in the envelopes and written in them and mixed randomly. . After the package is selected by the patient recipient, patients will be divided into desired groups.

The facilitator (supervisor) who is not involved in the collection and analysis of study data will be aware of the study groupings and the researcher, the data collector and the data analyzer will be blinded to the study groups. The subjects will not be aware of their behaviors during treatment. Patients will be assigned to study groups after their arrival using closed letter envelopes with numbers 1 to 90 on the envelopes and groups A and B written on the envelopes and mixed randomly. After the package is selected by the patient recipient, patients will be divided into desired groups. Envelopes will be arranged by the facilitator (supervisor) and study groups will be selected. Envelopes will be selected by the female resident. Envelopes will be numbered from number 1 to the end. The first person will be given the first envelope and this will continue until the last desired number, where 45 people will be in group A and 45 people in group B.