Uterine cavity coring before intra-uterine insemination in patients with unexplained infertility

Abstract

Introduction: Infertility, a major health problem nowadays, affects around 8-12% of couples worldwide. Unexplained infertility affects up to 15-30% of infertile couples. Management options for unexplained infertility are expectant management, timed intercourse, IUI with or without controlled ovarian stimulation, ART i.e IVF/intracytoplasmic sperm injection (ICSI). Endometrial mechanical injury in order to augment the probability of implantation of embryo and pregnancy rate has been particularly noted in recent years. Objectives: Evaluation of endometrial scratching on pregnancy rates after IUI. Material and methods: This interventional study was carried out in SMGS Hospital, GMC Jammu over a period of 18 months from July 2018 to December 2019. A total of 100 infertile women with unexplained infertility were included in the study and were randomly divided into two groups, 50 in each. The IUI procedure was carried out in the first group after the endometrial scratch on day 2-3 of menstrual cycle, while the control group underwent only IUI without any intervention. The pregnancy rates were compared in both the groups. Results: Among 100 patients who entered this study, 14 (14%) women got pregnant. There were 10 (10%) clinical pregnancies in the study group and 4 (4%) in the control group. Therefore 71% of the pregnant cases in this study were from the case group, showing the two-thirds of the success in treating infertile couple in this study belonged to scratching method. There was a significant difference in between both the groups. Conclusions: The uterine cavity coring (endometrial scratching) performed on day2-3 of the menstrual cycle, preceding IUI procedure, leads to a significant increase in pregnancy rate. On the other hand, this method can be employed with lower costs in comparison to other fertilisation methods.

To Analyse the Effect of Endometrial Scratching on Pregnancy Rates in Previously Failed Iui Cycles

“…The difference was statistically highly significant (p-value<0.0001). Dogra A et al 7 found that Mean endometrial thickness was comparable in both the cases (9.20 ± 3.37) and controls (9.16 ± 3.20). The difference was not statistically significant (p value=0.532).…”