BJOG : an international journal of obstetrics and gynaecology · 2017
Cervical mucus removal prior to intrauterine insemination: a randomized trial.
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СтатьяРандомизированное исследованиеОтозванная публикацияНазвание и аннотация: Перевод пока не подготовлен
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Maher M A, Sayyed T M, Elkhouly N
Аннотация
OBJECTIVE: To detect if removing the cervical mucus before performing intrauterine insemination (IUI) could improve pregnancy outcomes in patients with unexplained infertility.
DESIGN: Prospective randomized study.
SETTING: An Egyptian University Hospital.
POPULATION: Seven hundred and fourteen couples with unexplained infertility who underwent intrauterine insemination (IUI) with or without cervical mucus removal.
METHODS: 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.
MAIN OUTCOME MEASURES: The clinical pregnancy rate.
RESULTS: 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.
CONCLUSIONS: Cervical mucus removal before IUI could improve pregnancy outcomes in women with unexplained infertility.
TWEETABLE ABSTRACT: Cervical mucus removal before IUI can improve pregnancy outcomes.
DESIGN: Prospective randomized study.
SETTING: An Egyptian University Hospital.
POPULATION: Seven hundred and fourteen couples with unexplained infertility who underwent intrauterine insemination (IUI) with or without cervical mucus removal.
METHODS: 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.
MAIN OUTCOME MEASURES: The clinical pregnancy rate.
RESULTS: 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.
CONCLUSIONS: Cervical mucus removal before IUI could improve pregnancy outcomes in women with unexplained infertility.
TWEETABLE ABSTRACT: Cervical mucus removal before IUI can improve pregnancy outcomes.