Saad Ahmed Samy, Mohamed Khalid Abd Aziz
Obstetrics and Gynecology Department, Faculty of Medicine, Hawaa Fertility Center, Benha University, Benha, 13512 Egypt.
J Obstet Gynaecol India. 2023 Aug;73(4):336-342. doi: 10.1007/s13224-023-01791-7. Epub 2023 Aug 31.
This was a prospective randomized controlled trial in 200 cases presented with endometrial cavity fluid at the day of oocyte retrieval at a private fertility center from 2013 to 2021. The cases were randomized at day of ovum pickup into 2 groups: Group 1 (control group) ( = 100): conventional management with follow-up and reassessment by transvaginal ultrasound on day 5. Group 2 (interventional group) ( = 100): aspiration of the fluid was done and cases were given diosmin 500 mg 3 times per day till reassessment at embryo transfer day. In both groups, we proceeded with fresh embryo transfer if no fluid is present on day 5 or freeze-all policy if persistent fluid was detected.
Endometrial fluid on the 5th day was significantly higher in the control group (28.0%) than in the interventional group (6.0%) ( < 0.001). Regarding pregnancy rate, although being higher in the interventional group (54.3% vs 50.0%), the difference was not statistically significant ( = 0.5). It was found that the intervention was associated with risk reduction of endometrial fluid (OR = 0.168, 95% CI = 0.065-0.429, < 0.001.
Aspiration of endometrial cavity fluid with diosmin intake increased the likelihood of fresh embryo transfer and with a slightly better pregnancy rate compared to conservative management.Clinical trial number: NCT02158000, Date of registration: 6/6/2014, Date of initial enrollment (first patient recruiting): 1/11/2014, URL: https://clinicaltrials.gov/ct2/show/NCT02158000.
这是一项前瞻性随机对照试验，研究对象为2013年至2021年在一家私立生育中心取卵日出现子宫内膜腔积液的200例患者。这些患者在取卵日被随机分为两组：第1组（对照组）（n = 100）：采用常规管理，在第5天通过经阴道超声进行随访和重新评估。第2组（干预组）（n = 100）：进行积液抽吸，并给予患者地奥司明500毫克，每日3次，直至胚胎移植日重新评估。在两组中，如果第5天没有积液，则进行新鲜胚胎移植；如果检测到持续积液，则采取全冷冻策略。
对照组第5天的子宫内膜积液明显高于干预组（28.0%对6.0%）（P < 0.001）。关于妊娠率，虽然干预组较高（54.3%对50.0%），但差异无统计学意义（P = 0.5）。研究发现，干预与降低子宫内膜积液风险相关（OR = 0.168，95%CI = 0.065 - 0.429，P < 0.001）。
与保守管理相比，抽吸子宫内膜腔积液并摄入地奥司明增加了新鲜胚胎移植的可能性，妊娠率略高。临床试验编号：NCT02158000，注册日期：2014年6月6日，首次入组日期（首位患者招募）：2014年11月1日，网址：https://clinicaltrials.gov/ct2/show/NCT02158000 。
