Prospective randomized study for hydrotubation with or without lidocaine before intrauterine insemination in unexplained infertility

Morad, Ahmed; Abdelhamid, Ayman Ahmed

doi:10.1016/j.mefs.2012.06.003

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…In harmony with the current results the study conducted by Morad & Abdelhamid, 4 revealed that in terms of the number of completed cycles, the number of follicles >16 mm, and patient characteristics on the day of hCG injection, such as endometrial thickness and serum E2, there was no substantial variation between the groups.…”

Section: Discussionsupporting

confidence: 87%

“…1 Tubal flushing or hydrotubation, has previously been shown to improve the chances of attaining pregnancy in couples with UI or who are in the initial phases of endometriosis. 4 Hydrotubation may have a physical and immunological influence on fertility, such as inhibiting spermatozoa phagocytosis and changing levels of peritoneal factors like cytokines. 5 The goal of the research was to compare the effects of simple hydrotubation with 20 mL of saline and lidocaine one day before IUI vs no hydrotubation on pregnancy rates in individuals with unexplained infertility.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasonographic Hydrotubation versus No Hydrotubation Before Intrauterine Insemination

Tagreda¹,

Farahat²,

Mostafa³

2022

Al-Azhar International Medical Journal

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Background: Intrauterine insemination (IUI) is a common reproductive treating for unexplained infertility (UI). To achieve conception, washed sperm is put into the uterine cavity. The success rate of IUI with simultaneous ovulation induction is a hot topic of discussion. In cases of unexplained infertility, hydrotubation has resulted in a significantly higher conception rate. Aim of the work:To compare the effect of simple hydrotubation with 20 ml of saline and lidocaine one day before IUI with no hydrotubation on the conception rate in patients with unexplained infertility. Patients and methods: This prospective randomized controlled trial included 214 women with unexplained infertility who attended Alzhar University Hospitals' Gynecology Outpatient Clinics. Results: There was a statistically substantial variation between the two groups. Treatment results. Clinical pregnancy was observed in 50 (46.7 %) of included patients in group A. No OHSS was observed in both groups. Conclusion:Hydrotubation with lidocaine one day before to IUI is a safe and well-tolerated technique. When comparing to nohydrotubation, it resulted in a greater conception rate, with a substantial change for couples with unexplained infertility. No significant complications of the procedure were reported with no to mild pain according to VAS score. However, More research is needed to look at the dose-dependency of Lidocaine hydrotubation and the impact of multiple sessions on the incidence of clinical gestation in these individuals.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Ultrasonographic Hydrotubation versus No Hydrotubation Before Intrauterine Insemination

Tagreda¹,

Farahat²,

Mostafa³

2022

Al-Azhar International Medical Journal

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“…In addition, pertubation with dilute lidocaine in a balanced salt solution (10 to 20 ml), one day before intrauterine insemination, resulted in significant improvement in frequency of pregnancy (14.9% vs 3.2%) in women diagnosed with unexplained infertility, possibly because of the effect of lidocaine to reduce sperm phagocytosis [21,25]. However, another study of hydrotubation with low dose lidocaine in saline (20 ml) or saline alone, one day before intrauterine insemination, showed similar clinical frequency of pregnancy with or without lidocaine (17.4% vs 11.2%) in patients with unexplained infertility [22]. A review of 11 randomized trials showed that tubal flushing with oil soluble medium versus no intervention was associated with a significant increase in the frequency of pregnancy [23].…”

Section: Discussionmentioning

confidence: 97%

“…Although it is unknown whether hydrotubation increases fertility, hydrotubation may improve the frequency of pregnancy because it may mechanically dislodge dense material in the tubes [18]. Previous studies have used different volumes and contents of saline solution, but the duration of flushing (not time-limited) has not been described quantitatively [19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Time-limited hydrotubation combined with clomiphene citrate treatment for unexplained infertility

Yapça¹,

Delibaş²,

Karaca³

et al. 2015

Clin. Exp. Obstet. Gynecol.

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To evaluate time-limited hydrotubation combined with clomiphene citrate as treatment for unexplained infertility. Materials and Methods: In this unblinded, randomized controlled trial of patients who had unexplained infertility, 40 patients were treated with timelimited hydrotubation (saline, 20 ml; flushed within 20 to 30 seconds) and clomphene citrate (total, 70 cycles) and 40 patients were treated with clomiphene citrate alone (total, 74 cycles). All women underwent an ovulation induction protocol with clomiphene citrate (100 mg/d orally for five days, from day 3 to day 7 of the cycle). Hydrotubation was performed after detection of the dominant follicle. Results: There were 15 pregnancies in the 80 patients (19%) (total, 144 stimulated cycles; 10% pregnancies per cycle). The frequency of clinical pregnancy per cycle was significantly greater in patients who were treated with hydrotubation and clomiphene citrate (nine pregnancies per cycle [13%]) than those treated with clomiphene citrate alone (two pregnancies per cycle [3%]; odds ratio, 5.3; 95% confidence interval, 1.1 to 25.5; p ≤ 0.05). The frequency of pregnancy per patient (total, clinical, or chemical) was similar for the two treatment groups. The frequency of live birth or abortion per cycle or patient was similar between the two treatment groups. Conclusion: Time-limited hydrotubation and clomiphene citrate may increase the frequency of clinical pregnancy per cycle in women who have unexplained infertility.

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“…To our best knowledge, only few small low-quality RCTs have been published on the additional value of hydrotubation to the existing management (ovarian stimulation with or without IUI treatment), although the results are not univocal. [68][69][70] However, a protocol of an RCT on preovulatory uterine flushing with saline has been published in 2016, and this RCT may provide information on the effectiveness of hydrotubation, especially in low-resource countries. 71…”

Section: Hydrotubation (Tubal Flushing Not Monitored By Imaging Methods)mentioning

confidence: 99%

Tubal Flushing Treatment for Unexplained Infertility

et al. 2020

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Tubal patency testing was initially introduced as a diagnostic test. However, it has been observed that some tubal patency tests also have a therapeutic effect. This therapeutic effect can be influenced by the contrast medium used during tubal flushing. In this review, we discuss current evidence associated with different methods for tubal flushing and their potential impact on reproductive outcomes in women with unexplained infertility. Furthermore, we discuss their diagnostic accuracy, safety, and cost-effectiveness.

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Prospective randomized study for hydrotubation with or without lidocaine before intrauterine insemination in unexplained infertility

Cited by 6 publications

References 22 publications

Ultrasonographic Hydrotubation versus No Hydrotubation Before Intrauterine Insemination

Ultrasonographic Hydrotubation versus No Hydrotubation Before Intrauterine Insemination

Time-limited hydrotubation combined with clomiphene citrate treatment for unexplained infertility

Tubal Flushing Treatment for Unexplained Infertility

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