Goel Tuhina, Mahey Reeta, Bhatla Neerja, Kalaivani Mani, Pant Sangeeta, Kriplani Alka
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, 110049, India.
Department of Statistics, All India Institute of Medical Sciences, New Delhi, 110049, India.
J Assist Reprod Genet. 2017 Aug;34(8):1051-1058. doi: 10.1007/s10815-017-0949-8. Epub 2017 May 27.
To study the effect of endometrial scratching in infertile couples undergoing ovulation induction and intrauterine insemination (IUI) cycles.
A prospective randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India. One hundred forty-four women with primary/secondary infertility were recruited. Couples were either unexplained or male factor infertility. Subjects were randomized into intervention (scratching) and control group. All patients received ovulation induction with clomiphene citrate (day 2-6) 50 mg/day +75 IU HMG on days 6 and 7. In addition, endometrial scratching was done on day 8 of ovulation induction cycle in intervention group. All couples were planned for three cycles of ovulation induction and IUI over 6 months. After each failed cycle, couple was advised to try for natural conception for one cycle. Those who conceived were excluded from further analysis. Primary outcome was clinical pregnancy rate. Secondary outcome measures included conception rate, ongoing pregnancy, abortion and ectopic rate.
Baseline characteristics were comparable in both groups. Clinical pregnancy rate was significantly higher in intervention group (31.9%; 23/72) as compared to control group (16.7%; 12/72) (p value 0.030). On per cycle analysis, first IUI cycle had significantly high pregnancy rate (18.1%; 13/72) as compared to control group (5.6%; 4/72). Three patients in intervention group and one in control group conceived in wash out cycle. Ongoing pregnancy rate was significantly higher in scratching group (30.0%; 21/70) as compared to control group (15.7%; 11/70) (p value0.044).
Endometrial scratching can be used as a low cost-effective tool to improve clinical pregnancy and ongoing pregnancy rate in IUI cycles. Further large number studies are required to document its role in improving live birth rate.
CTRI/2015/12/006419.
研究子宫内膜搔刮术对接受诱导排卵和宫内人工授精（IUI）周期的不孕夫妇的影响。
在印度新德里全印医学科学研究所妇产科进行了一项前瞻性随机对照试验。招募了144名原发性/继发性不孕的女性。夫妇不孕原因要么是不明原因，要么是男性因素。将受试者随机分为干预组（搔刮术）和对照组。所有患者均接受枸橼酸氯米芬诱导排卵（第2 - 6天），剂量为50毫克/天，并在第6天和第7天注射75国际单位人绝经期促性腺激素。此外，干预组在诱导排卵周期的第8天进行子宫内膜搔刮术。所有夫妇计划在6个月内进行三个周期的诱导排卵和IUI。每个失败周期后，建议夫妇尝试自然受孕一个周期。那些受孕的夫妇被排除在进一步分析之外。主要结局是临床妊娠率。次要结局指标包括受孕率、持续妊娠、流产和异位妊娠率。
两组的基线特征具有可比性。干预组的临床妊娠率（31.9%；23/72）显著高于对照组（16.7%；12/72）（p值0.030）。在每个周期分析中，与对照组（5.6%；4/72）相比，第一个IUI周期的妊娠率显著更高（18.1%；13/72）。干预组有3名患者和对照组有1名患者在洗脱周期受孕。搔刮术组的持续妊娠率（30.0%；21/70）显著高于对照组（15.7%；11/70）（p值0.044）。
子宫内膜搔刮术可作为一种低成本有效的工具，提高IUI周期的临床妊娠率和持续妊娠率。需要进一步进行大量研究来证明其在提高活产率方面的作用。
CTRI/2015/12/0
