The Effects of Endometrial Scratching on Intrauterine Insemination Outcome in Patients with Unexplained Infertility: A Randomized Clinical Trial

Abstract

Intrauterine insemination (IUI) with or without ovarian stimulation is a common treatment for infertility. The rationale of IUI treatment is to increase the rate of conception in the couple by increasing the chance that maximum number of healthy sperm reaches the site of fertilization. The success rate of IUI with ovulation induction varies widely, with pregnancy rates ranging between 8 and 22% per cycle. Implantation failure and its associated defects remain as unresolved problem in reproductive medicine and are considered a major cause of infertility in otherwise healthy women. This study suggested that endometrial local injury using a modified cook catheter on day 7 of the IUI cycle improves the pregnancy rate: a randomized clinical trial. This study conducted in Ain Shams University Maternity Hospital (ART unit) from July 2015 to March 2016. The study included infertile women who would have an intrauterine insemination, 88 patients were included and divided randomly into two equal groups of 44 patients, in the case group endometrial local injury using a modified cook catheter on day 7 of the cycle of the IUI treatment was done.  Summary 83 All patients included in the study were subjected to detailed history taking and full examination. Basal hormonal profile and seminal fluid analysis were achieved. The endometrial injury was performed in the study group on day 7 of the cycle of IUI. All the included patients subjected to controlled ovarian stimulation (clomid and/or gonadotropins) with IUI. Pregnancy test was done after 14 days from the IUI if positive, transvaginal ultrasound was done 2 weeks later. The results of this study showed that the pregnancy rates in case group (18.2%) were higher than the pregnancy rates in control group (13.6%) but the difference was not significant.