|Endometrial Scratching Effect on Pregnancy Rate in Intra-Uterine Insemination Cycles, A Randomized Controlled Trial|
|Mina Naghi Jafarabadi1, Maryam Bagheri2, Zahra Ebrahimi3, Mamak Shariat4, Fedyeh Haghollahi5, Azam Tarafdari6|
|1Vali - Asr Reproductive Health Research Center, Tehran University Of Medical Sciences,Tehran,Iran
2Department of Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
3Ziaeian Hospital, Tehran University of Medical Sciences Tehran, Iran
4Family Health Institute, Maternal-Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
5Reproductive Health Research Center, Tehran University of Medical Sciences Tehran, Iran
6Vali - Asr Reproductive Health Research Center, Tehran University Of Medical Sciences, Tehran, Iran
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Keywords : Infertility, Pregnancy, Endometrial receptivity, Endometrial scratching
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Objectives:This study was aimed to examine the endometrial scratch injury (ESI) effect to improve pregnancy rate in women undergoing IUI.
Materials and Methods :This is a randomized controlled clinical trial conducted in a University Clinic from November 2017 to January 2019. One hundred-twenty candidate entered the study who were separated to two groups of intervention (n=60) and control (n=60). All subjects underwent controlled ovarian stimulation using Letrozole 2.5 mg /BD on a day between 3 and 7 of the cycle. Then, the sonographic monitoring was started from day 8 of the cycles. When 1-2 follicles reached 18 mm in diameter, HCG 10000 IU was injected intramuscularly. Approximately 36-38 hours afterwards, IUI was done and a B-HCG test was performed after 15 days. Luteal phase support was performed with the vaginal progesterone 400 mg twice daily for 15 days. In the intervention group, in addition to the routine procedure, on day 3 of the cycle endometrial cavity on the posterior wall was scratched with the vaginal cannula No. 4 by a single infertility specialist. The main outcome measurements were the chemical and clinical pregnancy rate.
Results:The overall clinical pregnancy rates in the intervention and control group were 11/59 (18.6%) and 10/59(16.9%) respectively (p=0.810). The abortion rates were respectively 1/59 (1.7%) and 3/59(5.1%) in intervention and control groups, (p=0.303). No cases of ectopic pregnancy were seen in either group.
Conclusion:Based on the findings of this study, endometrial scratch by pipelle does not improve pregnancy rate in the early proliferative phase.
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