scholarly journals Comparison of pregnancy outcome in intrauterine insemination-candidate women with and without endometrial scratch injury: An RCT

Author(s):  
Mahnaz Yavangi ◽  
Nesa Varmaghani ◽  
Azar Pirdehghan ◽  
Maryam Varmaghani ◽  
Mohammad Faryadras

Background: Endometrial scratch injury is considered controversial in increasing the success rate of assisted reproductive technology. Objective: To compare the pregnancy outcomes in women undergoing intrauterine insemination with and without an endometrial scratch. Materials and Methods: In this randomized clinical trial, 150 women referred to the Fatemieh Hospital, Hamadan, Iran who were candidates for IUI between December 2017 and December 2018 were randomly assigned into two groups (n = 75/each) with or without an endometrial scratch (as case and control groups, respectively). Women in both groups were in proper and identical protocol for IUI. Chemical and clinical pregnancies, abortion, and live birth rate, also pregnancy complications were compared between the groups. Results: Chemical and clinical pregnancy rates were higher in the case than the control group (p = 0.25, p = 0.54, respectively). In the case group, the abortion and multiple gestation rates were 14.3% and 4.3%, respectively, while it was 5% in the control group (p = 0.60, p = 0.54 respectively). The endometrium thickness on day 21 was higher in the case group than the control (p = 0.01). Conclusion: Endometrial scratching in intrauterine insemination women is not associated with an increase in both clinical and clinical pregnancy rates, however, studies with a larger sample size are recommended to evaluate this intervention. Key words: Pregnancy infertility, Women, Endometrial injury, Pregnancy, Intrauterine insemination.

Author(s):  
Mina Naghi Jafarabadi ◽  
Maryam Bagheri ◽  
Zahra Ebrahimi ◽  
Mamak Shariat ◽  
Fedyeh Haghollahi

Objectives : This study was aimed to examine the endometrial scratch injury effect to improve pregnancy rate in women undergoing intrauterine insemination (IUI). Materials and Methods: This randomized controlled clinical trial was conducted in a University Clinic from November 2017 to January 2019. A total of 120 candidates entered the study, who were assigned to intervention (n=60) and control (n=60) groups. 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, followed by injecting human chorionic gonadotropins (HCG) 100001U intramuscularly when 1-2 follicles reached 18 mm in diameter. Approximately 36-38 hours afterward, IUI was done and a B-HCG test was performed after 15 days as well. In addition, luteal phase support was performed with the vaginal progesterone 400 mg twice daily for 15 days. In the intervention group, 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 in addition to the routine procedure. The chemical and clinical pregnancy rates were the main outcome measurements. Results: The overall clinical pregnancy rates were 11/59 (18.6%) and 10/59 (16.9%) in intervention and control groups, respectively (P=0.810). Further, the abortion rates were 1/59 (1.7%) and 3/59 (5.1%) in intervention and control groups, respectively (P=0.303). Eventually, no cases of ectopic pregnancy were observed in either group. Conclusions: Based on the findings of this study, endometrial scratch by pipelle cannot improve pregnancy rate in the early proliferative phase.


Author(s):  
Robabe Hosseinisadat ◽  
Lida Saeed ◽  
Sareh Ashourzadeh ◽  
Sedigheh Safar Heidari ◽  
Victoria Habibzadeh

Background: Several mediators play an important role in implantation. One of these mediators is human chorionic gonadotropin (HCG). Objective: To evaluate the effects of HCG intrauterine injection on the day of oocyte retrieval on the result of assisted reproductive techniques (ART). Materials and Methods: In this randomized clinical trial study, 126 women who were referred to Afzalipour Infertility Center between December 2018 to December 2019 undergoing in vitro fertilization/intracytoplasmic sperm injection cycles were enrolled and assigned to two groups of: a case (n = 62) and a control group (n = 64). The protocols for both groups were the same; except that the case group was injected with the protocols for both groups were the same, except that the case group was injected with 1000 IU of HCG into uterine cavity following the oocyte puncture, while no medication was administered to the control group. The implantation rate, chemical pregnancy, clinical pregnancy, and abortion rates were compared between the two groups. Results: Positive chemical pregnancy was seen in 15 (27.3%) cases of the case group and 14 (25.5%) of the control group. No significant difference was seen in the chemical and clinical pregnancy rates between the groups. The abortion rate was higher in the control group but that was not significant. Conclusion: A 1000 IU of HCG intrauterine injection after oocyte retrieval does not improve implantation, chemical or clinical pregnancy rates in ART cycles. Further studies are needed to clearly understand the role of HCG intrauterine injection in the day of oocyte retrieval in ART outcomes. Key words: Oocyte retrieval, Chorionic gonadotropin, Pregnancy, Assisted reproductive techniques.


Author(s):  
Enis Ozkaya ◽  
Ebru Cogendez ◽  
Elif Tozkir ◽  
Saadet Unsal ◽  
Ahmet Yavuz ◽  
...  

OBJECTIVE: This study aimed to compare cycle outcomes among women with endometrioma or non-functional cysts versus control. STUDY DESIGN: Women under 35 years of age with unexplained infertility underwent in vitro fertilization cycle. Two hundred and ninety-nine women were included in this study. Study groups consist of women with endometrioma (n=82) or non-functional ovarian cysts (n=100) and control group (n=117). Women in each group were selected consecutively. Groups were matched for age and ovarian reserve and compared in terms of in vitro fertilization cycle outcome. RESULTS: There were no significant differences among groups in terms of mean age, early follicular phase Follicle-Stimulating Hormone, and anti-müllerian hormone levels (p>0.05). Baseline total antral follicle counts were similar among groups (p>0.05). There were significant differences among groups in terms of mean starting and total gonadotropin dose, peak estradiol level, total oocyte number, and mature oocyte numbers (p<0.05). Clinical pregnancy rates were 10.7%, 17.3%, and 31.6% in groups with non-functional cyst, endometrioma and control group respectively (p<0.05). The presence of a non-functional cystic mass of ovary on the starting day of stimulation was a risk factor for poor cycle outcome in terms of clinical pregnancy rates [OR=0.5 (95 % CI; 0.2-0.9, p=0.03)]. CONCLUSION: Our data showed that the presence of any kind of cystic mass of the ovary especially the non-functional cysts on the starting day of stimulation was a risk factor for poor cycle outcomes in terms of clinical pregnancy rates.


2014 ◽  
Vol 102 (3) ◽  
pp. 739-743 ◽  
Author(s):  
Shvetha M. Zarek ◽  
Micah J. Hill ◽  
Kevin S. Richter ◽  
Mae Wu ◽  
Alan H. DeCherney ◽  
...  

Author(s):  
Bulent Emre Bilgic ◽  
Enis Ozkaya ◽  
Cigdem Yayla Abide ◽  
Semra Kayatas Eser ◽  
Ilhan Sanverdi ◽  
...  

<p><strong>Objective:</strong> The objective of this study was to investigate the effect of total or partial assisted hatching on the clinical pregnancy rates in assisted reproduction technology.</p><p><strong>Study Design:</strong> This was a case-control study conducted from the beginning of January 2016 to the end of June 2017. A total of 404 cycles were included in this case-control study. Study population was divided into 3 groups: Group 1: Partial assisted hatching (n=118), Group 2: Total assisted hatching (n=81) and Control group (n=205).</p><p><strong>Results:</strong> In women of all ages, clinical pregnancy rates were similar between groups with total or partial assisted hatching compared to control group (p&gt;0.05). The rates were also similar in subgroups of women with blastocyst or cleavage stage embryo transfers (p&gt;0.05). Partial or total embryo hatching did not result in favorable outcome compared to control group either in women over 35 or younger than 35 years of age (p&gt;0.05). In whole study group pregnancy rate was significantly higher in group with blastocyst stage embryo transfers (22.4 % versus 48.8%, p&lt;0.05)</p><p><strong>Conclusion:</strong> Partial or total assisted hatching do not have any impact on the clinical pregnancy rates, no significant impact was determined in subgroup of women either.</p>


Author(s):  
Farahnaz Farzaneh ◽  
Farzaneh Khastehfekr

Background: The prevalence of infertility is increasing worldwide and the treatment is one of the important issues. Objective: This study aimed to evaluate the effect of local endometrial scratching on pregnancy outcomes in women with previous failure of intrauterine insemination. Materials and Methods: This non-randomized clinical trial study was performed on 336 women referred to the infertility clinic of Ali ebn-e Abitaleb Hospital of Zahedan (between May and November 2019). Women were divided into two groups: endometrial scratch as case and a control group. In the case group (n = 173), endometrial scratching was performed on days 8–9 of the menstrual cycle in addition to routine infertility treatments, while in the control group (n = 163), only routine treatment was performed. Chi-square test was used to compare the frequency of male factor severity and the percentage of successful pregnancies between both groups and was used to investigate the effect of male factor on the fertility rate in each group (moderate male factor and mild male factor). Results: The mean age of the women was 28.4 ± 5.2 yr. The success rate of pregnancy in the case group was 12.3% and in the control group 11%, which were not statistically significant (p = 0.697). Conclusion: Overall, the results of this study showed that endometrial scratching had no effect on the pregnancy rate. Key words: Infertility, Endometrial, Scratch, Insemination.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Müge Keskin ◽  
Ruşen Aytaç

Intrauterine insemination (IUI) is a common treatment for couples with subfertility. Clomiphene citrate, gonadotropins, and letrozole are used for ovulation induction in IUI cycles. It has been well documented that luteal support with exogenous progesterone after in vitro fertilization is associated with higher pregnancy and live birth rates. Yet, luteal phase support in IUI cycles has become a debatable issue. The aim of this prospective controlled study was to assess the effect of luteal phase vaginal progesterone supplementation on β-hCG positivity and clinical pregnancy rates in women undergoing IUI. This prospective controlled randomised study was conducted at a tertiary infertility center. 87 patients with unexplained infertility or male subfertility who were treated with IUI using gonadotropins were enrolled. Patients in the study group (n = 44) received luteal phase vaginal progesterone supplementation. Patients in the control group (n = 43) did not receive any luteal phase support. There was no statistical difference between two groups in terms of β-hCG positivity and clinical pregnancy rates. Our findings do not show any beneficial effect of luteal phase support in IUI cycles stimulated with gonadotropins. Although luteal phase support in IUI cycles stimulated with gonadotropins is widely adopted, there is a lack of robust evidence.


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