Tarek Shokeir1, Mohamed Ebrahim1, Hosam El-Mogy2. 1. Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. 2. Department of Obstetrics and Gynecology, Mansoura University Hospital, Mansoura Faculty of Medicine, Mansoura, Egypt. tarek.shokeir@gmail.com.
Abstract
AIM: To evaluate the efficacy of a hysteroscopic site-specific local endometrial injury (LEI) in a group of women with unexplained infertility (UI) undergoing expectant management with no fertility treatment versus no intervention. METHODS: This open-label, randomized controlled trial (RCT) was conducted between June 2013 and July 2015. Hysteroscopic site-specific LEI was determined by patient identification number, and 120 women were included. Eligible participants were randomly assigned to receive either a single, site-specific LEI guided by hysteroscopy (study group, n = 60) or no intervention (control group, n = 60). Natural cycle folliculometry and timed intercourse were carried out for all participants for 3 months. Successful clinical pregnancy confirmed on ultrasound was the primary outcome measure, and first trimester miscarriage rate was the secondary outcome. RESULTS: After identification, baseline clinical demographics were similar in the two groups. No statistically significant differences were noted in cumulative pregnancy rates in women with LEI compared with those without (16.7% and 11.7 %, respectively; OR, 2.83; 95%CI: 1.07-7.48; P = 0.4). One first trimester miscarriage was reported in the control group (14.3%). CONCLUSION: Local endometrial injury for natural cycle conception in women with UI is not justified. Further RCT are warranted to prove or disprove this.
RCT Entities:
AIM: To evaluate the efficacy of a hysteroscopic site-specific local endometrial injury (LEI) in a group of women with unexplained infertility (UI) undergoing expectant management with no fertility treatment versus no intervention. METHODS: This open-label, randomized controlled trial (RCT) was conducted between June 2013 and July 2015. Hysteroscopic site-specific LEI was determined by patient identification number, and 120 women were included. Eligible participants were randomly assigned to receive either a single, site-specific LEI guided by hysteroscopy (study group, n = 60) or no intervention (control group, n = 60). Natural cycle folliculometry and timed intercourse were carried out for all participants for 3 months. Successful clinical pregnancy confirmed on ultrasound was the primary outcome measure, and first trimester miscarriage rate was the secondary outcome. RESULTS: After identification, baseline clinical demographics were similar in the two groups. No statistically significant differences were noted in cumulative pregnancy rates in women with LEI compared with those without (16.7% and 11.7 %, respectively; OR, 2.83; 95%CI: 1.07-7.48; P = 0.4). One first trimester miscarriage was reported in the control group (14.3%). CONCLUSION: Local endometrial injury for natural cycle conception in women with UI is not justified. Further RCT are warranted to prove or disprove this.
Authors: Mohan S Kamath; Jan Bosteels; Thomas M D'Hooghe; Srividya Seshadri; Steven Weyers; Ben Willem J Mol; Frank J Broekmans; Sesh Kamal Sunkara Journal: Cochrane Database Syst Rev Date: 2019-04-16
Authors: Bich Ngoc Bui; Sarah F Lensen; Ahmed Gibreel; Wellington P Martins; Helen Torrance; Frank J Broekmans Journal: Cochrane Database Syst Rev Date: 2021-03-18
Authors: B N Bui; H L Torrance; C Janssen; B Cohlen; J P de Bruin; J E den Hartog; P J Q van der Linden; K L Deurloo; J W M Maas; R van Oppenraaij; A Cantineau; C B Lambalk; H Visser; E Brinkhuis; J van Disseldorp; B C Schoot; C Lardenoije; M van Wely; M J C Eijkemans; F J M Broekmans Journal: BMC Pregnancy Childbirth Date: 2018-12-29 Impact factor: 3.007