Effect of cervical mucus aspiration before intrauterine insemination

Şimşek, Erhan; Haydardedeoğlu, Bülent; Hacıvelioğlu, Servet; Çok, Tayfun; Parlakgümüş, Alper; Bağış, Tayfun

doi:10.1016/j.ijgo.2008.05.030

Cited by 10 publications

(21 citation statements)

References 15 publications

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“…When considering cervical mucus aspiration before IUI, Simsek et al found it to be associated with improved pregnancy outcomes (24% in the mucus‐aspiration group versus 9.5% in the non‐aspiration group, P = 0.04). In their randomized trial, Ghasemi et al reported a clinical pregnancy rate of 14.2% among cases of unexplained infertility who underwent mucus removal before insemination ( P = 0.04; OR, 2.199; CI 95%, 0.997–4.85).…”

Section: Discussionmentioning

confidence: 97%

“…The results of the present study show that removal of the cervical mucus from the internal and external cervical os before IUI can improve pregnancy outcomes in women with unexplained infertility. The exact mechanism by which cervical mucus removal can enhance pregnancy outcomes is still insufficiently studied, but once this mucus is present, especially if abundant, it may: cause failure of insemination by reducing release of sperm from the catheter; interfere with sperm–oocyte interaction; or push possibly contaminated mucus into the uterine cavity where it may either kill the newly formed embryos or hinder their attachment to the endometrium by stimulating uterine contractions …”

Section: Discussionmentioning

confidence: 99%

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Retracted: Cervical mucus removal prior to intrauterine insemination: a randomized trial

Maher

Sayyed

Elkhouly

2017

BJOG

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Objective To detect if removing the cervical mucus before performing intrauterine insemination (IUI) could improve pregnancy outcomes in patients with unexplained infertility.Design Prospective randomized study.Setting An Egyptian University Hospital.Population Seven hundred and fourteen couples with unexplained infertility who underwent intrauterine insemination (IUI) with or without cervical mucus removal.Methods Using computer-generated numbers, patients were randomly allocated to cervical-mucus-removal (removed from both internal and external os) or non-mucus-removal groups. Only participants were blinded as to group assignment.Main outcome measures The clinical pregnancy rate.Results Of 714 IUI patients between November 2014 and March 2017, 361 were in the mucus removal group, and 353 in the nonmucus-removal group. Difficult catheterization was encountered in 17 cases out of 666 (2.6%) 12 in the cervical-mucus-removal group and five in the non-mucus-removal group). A total of 666 IUI cycles were completed while 48 were either cancelled or lost in their follow-up. The clinical pregnancy rate was significantly higher in the mucus-removal group [31.0% (n = 112)] than in the non-mucus-removal group [21.8% (n = 77); P = 0.005]. Ovarian hyperstimulation developed in 33 (4.6%) cases: 18 cervical mucus-removal and 15 non-mucus-removal. All except one were mild and managed with outpatient care.Conclusions Cervical mucus removal before IUI could improve pregnancy outcomes in women with unexplained infertility.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Retracted: Cervical mucus removal prior to intrauterine insemination: a randomized trial

Maher

Sayyed

Elkhouly

2017

BJOG

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“…In Erhan Simsek study in 2008 cervical mucus aspiration before IUI improved outcome of IUI [11]. It should be mentioned the difference between our study with Simsek study was using swab for CM clinging instead of CM aspiration through the catheter.…”

Section: Discussionmentioning

confidence: 68%

Effect of Cervical Canal Cleaning on IUI Outcome

A¹,

Berjis²,

Asbagh³

2012

J Fertiliz In Vitro

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IntroductionIntra-uterine insemination (IUI) is one of the most frequently used fertility treatments for couples with male subfertility. Its specifically procedure is well known for women with low fertility [1,2]. Ordinary for sub fertile men and unexplained infertility Intra uterine insemination is used as a known treatment [3]. With regard to commonly available, economical and less invasive of this method in versus more complex and expensive treatment, thus many studies have been done for more success of IUI. The effect of different variable on IUI out come has been well studied including: timing of IUI, single or double method, type of cutter, different induction protocol, insemination volume and different method of IUI [4][5][6][7]. As a reserve sores of sperm during normal intercourse cervical mucus (CM) is the important factor [8]. Existence of inappropriate cervical mucus and presence of anti sperm antibody causes some type of infertility [1]. While IUI can avoid cervical mucus and its undesirable properties but some of its effects still be present. There is not enough study to evaluate the role of cervical canal cleaning in outcome of pregnancy in IUI. In one study cervical mucus aspiration before embryo transfer improved pregnancy rate [9]. In some researches unwanted effects of cervical mucus in transferred embryo have been studied [9,10].In the other hand unwanted entered mucus to endometrial cavity with catheter in IUI can causes some reverse effects on sperm motility in sperm-oocyte interaction. With regard to this experiment we decided evaluating cervical mucus removing with swab in out come of IUI. This study is planed for, if cervical mucus removal before IUI improve outcome of IUI and increase pregnancy rate? Material and MethodThis study was performed in Mirza koochak Khan infertility center of Tehran University between 2008/9/1 till 2009/9/30. In infertility evaluation, some cases of moderate male infertility according WHO criteria's and women who have no reason for infertility as unexplained infertility entered in IUI cycle. In this open labeled study 310 couples underwent in the study. They were randomly divided two groups according to whether the cervical mucus has been cleaned or not. Intra uterine insemination with swab was done for 154 patients (treated group) and IUI without swab were done for 156 patients (control group). Primary assessment and complete physical examination for both groups have been done. Semen analysis and hormonal assessment (from second or third day and in 19 to 21 days of menstrual cycle) were done for all cases. Also to role out tubal factor of infertility histrosal pangography (HSG) were done for all cases. Semen analysis evaluation had been done with WHO criteria's (sperm count more than 20 millions per cc, morphology more than 30 % normal shape, motility more than 50% motion sperm and volume more than 2 cc) and then cases with sever male factors infertility included motility, count and morphology excluded from this study. However, women with regular menstrual c...

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“…Tubal flushing has previously proved to be one way of increasing the chance of acheiving pregnancy for couples with increased infertility and early stage of endometriosis 8 . Hydrotubation treatment can be administered in an outpatient clinic and represents a less invasive treatment alternative 9 . The effect of hydrotubation on fertility can be mechanical as well as immunological like inhibited phagocytosis of spermatozoa and by affecting level of peritoneal factors such as cytokines 10 .…”

Section: Introductionmentioning

confidence: 99%

“…It can act by dislodgement of debris in fallopian tubes or by separating the loose adhesion of the tubes. It can also remove thick hostile cervical mucus which may hinder the passage of sperms through the cervix 9 . There may be stimulation of peristalsis by flushing of fluid and dilution of toxic factors such as cytokines in endometriosis 7 .…”

Section: Introductionmentioning

confidence: 99%

Effect of Saline Sonosalpingography in Unexplained Infertility

2018

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Background: Saline sonosalpingography is a simple technique that has previously proved to be one way of increasing the chance of achieving pregnancy for couples with unexplained infertility. Objective: The purpose of the present was to evaluate the pregnancy rate following saline sonohysterography in stimulated cycles for couples with unexplained infertility. Methodology: This study was designed as prospective randomized controlled trial which was carried out for a period of two years from January 2015 to December 2016. Women with unexplained infertility were selected randomly for saline sonosalpingography and the procedure was carried out three to four days before ovulation in stimulated cycle. Outcomes measure were rate of pregnancy, first trimester abortion, multiple pregnancy, ectopic etc. Result: In this study total number of 55 patients were recruited for this study and saline sonosalpingography was performed over 2(two) years. Age range was from 23 to 42 years. Maximum patients are within the age range of 23 to 27 years. Among 55 patients, 23 were pregnant. Pregnancy rate was 41.81% cases. Singleton pregnancy without any complication was 52.17% cases. Twin pregnancy rate was 13.01% cases. Among them twin with single fetus demise was 4.3% cases, missed abortion 21.7% cases and ectopic was 8.7% cases. Conclusion: With good case selection, therapeutic hydrotubation may be beneficial in resource poor countries, especially in patients with incomplete tubal occlusion bilateral perifimbrial adhesions and as part of treatment for unexplained infertility. This demonstrates increased chance of pregnancy in this group. So further evaluation is needed to upgrade the result of the study.

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Effect of cervical mucus aspiration before intrauterine insemination

Abstract: Cervical mucus aspiration before IUI might improve clinical pregnancy rates by yet-to-be-defined mechanisms.

Cited by 10 publications

References 15 publications

Retracted: Cervical mucus removal prior to intrauterine insemination: a randomized trial

Retracted: Cervical mucus removal prior to intrauterine insemination: a randomized trial

Effect of Cervical Canal Cleaning on IUI Outcome

Effect of Saline Sonosalpingography in Unexplained Infertility

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