Obstetrics and Gynaecology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt.
Al-Hayat National Hospital, Khamis-Mushait, Saudi Arabia.
BJOG. 2018 Jun;125(7):841-847. doi: 10.1111/1471-0528.15003. Epub 2017 Dec 8.
To detect if removing the cervical mucus before performing intrauterine insemination (IUI) could improve pregnancy outcomes in patients with unexplained infertility.
Prospective randomized study.
An Egyptian University Hospital.
Seven hundred and fourteen couples with unexplained infertility who underwent intrauterine insemination (IUI) with or without cervical mucus removal.
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.
The clinical pregnancy rate.
Of 714 IUI patients between November 2014 and March 2017, 361 were in the mucus removal group, and 353 in the non-mucus-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.
Cervical mucus removal before IUI could improve pregnancy outcomes in women with unexplained infertility.
Cervical mucus removal before IUI can improve pregnancy outcomes.
检测在进行宫腔内人工授精（IUI）前清除宫颈黏液是否可以改善不明原因不孕患者的妊娠结局。
前瞻性随机研究。
埃及一所大学医院。
714 对接受宫腔内人工授精（IUI）的不明原因不孕夫妇，其中包括宫颈黏液清除组和非宫颈黏液清除组。
使用计算机生成的数字，将患者随机分配至宫颈黏液清除组（从内口和外口均清除）或非宫颈黏液清除组。只有参与者对分组不知情。
临床妊娠率。
2014 年 11 月至 2017 年 3 月期间，714 例 IUI 患者中，361 例在黏液清除组，353 例在非黏液清除组。在 666 例中有 17 例（2.6%），12 例在黏液清除组，5 例在非黏液清除组出现了导管插入困难。共有 666 个 IUI 周期完成，48 个在随访中被取消或丢失。黏液清除组的临床妊娠率明显高于非黏液清除组[31.0%（n=112）比 21.8%（n=77）；P=0.005]。33 例（4.6%）发生卵巢过度刺激：18 例黏液清除组，15 例非黏液清除组。除 1 例外，所有患者均为轻度，通过门诊治疗。
在 IUI 前清除宫颈黏液可以改善不明原因不孕妇女的妊娠结局。
IUI 前清除宫颈黏液可提高妊娠结局。
