Mahnaz Ashrafi1,2,3, Ensieh Shahrokh Tehraninejad1,3,4, Mansooreh Haghiri3,4, Masoumeh Masomi4, Shahideh Jahanian Sadatmahalleh5, Arezoo Arabipoor1. 1. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran. 2. Obstetrics and Gynecology Department, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran. 3. Obstetrics and Gynecology Department, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran. 4. Vali-e-Asr Reproductive Health Research Center, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. 5. Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
Abstract
AIM: Endometrial scratch injury (ESI) has been recently proposed to enhance the implantation rate in assisted reproductive technology cycles. The present study was conducted to determine the effect of ESI on pregnancy rate in women with intrauterine insemination (IUI) failure. METHODS: This prospective randomized controlled study was carried out in Imam-Khomeini Hospital and Royan Institute, Tehran, during a 12-month period from January 2013 to January 2014. After assessment, 169 patients who had IUI failure twice or more (no chemical or clinical pregnancy) with normal uterine anatomy and hysterosalpingography, were enrolled. They were randomly assigned into two groups. In the experimental group, all patients underwent ESI at day 8 or 9 of stimulation phase in the present IUI cycle, whereas no intervention was performed on the control group. IUI outcome was then compared between the two groups. RESULTS: A total of 150 patients completed the IUI cycle during the study. The chemical pregnancy rate was 10.7% and 2.7% in the experimental and control groups, respectively, without significant difference (P = 0.09). Also no significant differences were detected in terms of clinical pregnancy and miscarriage rates between the two groups (P > 0.05). CONCLUSIONS: No significant beneficial effect of ESI on fertility outcome in patients with repeated IUI failure was detected when it was carried out on day 8 or 9 of the same IUI stimulation cycle. Also, however, no negative impact secondary to ESI was observed. Therefore, confirmation or refutation of this hypothesis requires further studies with a larger sample size. IRCT201507271141N19.
RCT Entities:
AIM: Endometrial scratch injury (ESI) has been recently proposed to enhance the implantation rate in assisted reproductive technology cycles. The present study was conducted to determine the effect of ESI on pregnancy rate in women with intrauterine insemination (IUI) failure. METHODS: This prospective randomized controlled study was carried out in Imam-Khomeini Hospital and Royan Institute, Tehran, during a 12-month period from January 2013 to January 2014. After assessment, 169 patients who had IUI failure twice or more (no chemical or clinical pregnancy) with normal uterine anatomy and hysterosalpingography, were enrolled. They were randomly assigned into two groups. In the experimental group, all patients underwent ESI at day 8 or 9 of stimulation phase in the present IUI cycle, whereas no intervention was performed on the control group. IUI outcome was then compared between the two groups. RESULTS: A total of 150 patients completed the IUI cycle during the study. The chemical pregnancy rate was 10.7% and 2.7% in the experimental and control groups, respectively, without significant difference (P = 0.09). Also no significant differences were detected in terms of clinical pregnancy and miscarriage rates between the two groups (P > 0.05). CONCLUSIONS: No significant beneficial effect of ESI on fertility outcome in patients with repeated IUI failure was detected when it was carried out on day 8 or 9 of the same IUI stimulation cycle. Also, however, no negative impact secondary to ESI was observed. Therefore, confirmation or refutation of this hypothesis requires further studies with a larger sample size. IRCT201507271141N19.
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