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The Effect of Endometrial Scratch Injury on Pregnancy Outcome in Women With Previous Intrauterine Insemination Failure: A Randomized Clinical Trial Publisher Pubmed



Ashrafi M1, 2, 3 ; Tehraninejad ES1, 3, 4 ; Haghiri M3, 4 ; Masomi M4 ; Sadatmahalleh SJ5 ; Arabipoor A1
Authors
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Authors Affiliations
  1. 1. Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
  2. 2. Obstetrics and Gynecology Department, Faculty of Medicine, Iran University of Medical Science, Tehran, Iran
  3. 3. Obstetrics and Gynecology Department, Faculty of Medicine, Tehran University of Medical Science, Tehran, Iran
  4. 4. Vali-e-Asr Reproductive Health Research Center, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Reproductive Health and Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran

Source: Journal of Obstetrics and Gynaecology Research Published:2017


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. © 2017 Japan Society of Obstetrics and Gynecology
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