title: Sildenafil citrate decreased natural killer cell activity and enhanced chance of successful pregnancy in women with a history of recurrent miscarriage.
abstract: OBJECTIVE
  To evaluate the effect of sildenafil on peripheral natural killer (NK) cell activity in women with a history of recurrent miscarriage (RM).
  
  
  METHODS
  Observational study.
  
  
  METHODS
  University teaching hospital.
  
  
  METHODS
  Thirty-eight nonpregnant women with a history of RM and 37 healthy women with previous successful pregnancy outcomes.
  
  
  METHODS
  Patients self-administered sildenafil suppositories (25 mg intravaginally, four times a day) for 36 days.
  
  
  METHODS
  Peripheral blood NK-cell activity before and after vaginal sildenafil therapy in the RM women was measured using flow cytometry. In addition, the influence of 10 microg and 400 ng sildenafil on NK-cell activity after in vitro culture were determined. Uterine artery blood flow and endometrial thickness were recorded using Doppler ultrasound with an intravaginal probe.
  
  
  RESULTS
  The NK-cell activity was significantly decreased after vaginal sildenafil therapy. Endometrial thickness was significantly increased after such therapy.
  
  
  CONCLUSIONS
  Vaginal sildenafil might be an interesting therapeutic option before conception in women with histories of reproductive failure.
authors.affiliation: Department of Gynecology and Gynecologic Oncology, Military Institute of Health Sciences, Warsaw, Poland.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Jerzak
authors.forename: Monika
authors.initials: M
authors.lastname: Kniotek
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Mrozek
authors.forename: Andrzej
authors.initials: A
authors.lastname: Górski
authors.forename: Wlodzimierz
authors.initials: W
authors.lastname: Baranowski
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology / Q000276:immunology / Q000503:physiopathology / Q000517:prevention & control*; D000282:Administration, Intravaginal; D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging / Q000187:drug effects; D002478:Cells, Cultured; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage / Q000627:therapeutic use*; D005307:Fertilization in Vitro / Q000009:adverse effects; D006801:Humans; D007694:Killer Cells, Natural / Q000187:drug effects*; D050498:Live Birth; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011247:Pregnancy; D018873:Pregnancy Rate; D011687:Purines / Q000008:administration & dosage / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D000068677:Sildenafil Citrate; D013450:Sulfones / Q000008:administration & dosage / Q000627:therapeutic use*; D013488:Suppositories; D017211:Treatment Failure; D018608:Ultrasonography, Doppler; D014599:Uterus / Q000098:blood supply*
chemical_list: D005300:Fertility Agents, Female; D010879:Piperazines; D011687:Purines; D013450:Sulfones; D013488:Suppositories; D000068677:Sildenafil Citrate