Authors: Ahmed Abdelkader Fahmy*, Mohammed El-Sherbeiny, Amro AbdelAziz

Abstract

To evaluate the impact of preovulatory human chorionic gonadotrophin (HCG) uterine flushing on implantation rate in women with unexplained infertility receiving intrauterine insemination (IUI).This was a prospective study performed at Ain Shams University Maternity Hospital, over a 3-year period, between June 2012 and June 2015, and included 300 women who were presented at the infertility clinic and scheduled for having IUI. Participant ages ranged from 18 to 37 years, the patients were divided randomly into two equal groups; group I (test group, N=150) included women who had preovulatory HCG endometrial flush followed by IUI and the other group (control group, N=150) who had IUI only without HCG endometrial flushing.  The outcome of interest is the difference in the rate of biochemical and clinical pregnancies, resulting from one cycle of treatment, between the two intervention groups. The outcomes of 300 cycles were analysed, the biochemical and clinical pregnancy rates in group I (test group) were (27.3%, 22% respectively while in group II (control group) were21.3%, 16% respectively with significant difference between the two groups (P<0.05), (44.7%) of patients experienced mild discomfort, moderate discomfort in (28.7%), severe discomfort in (11.3%), also patient acceptability was high (68%).  Difficult flushing was present in 14.7% of cases. The side effects were low in general but higher than in group II with significal difference between the two groups (nausea was present in 21.3% of cases of group I Vs 6.7 in group II, vomiting in 10% in group I Vs 2% in group II, abdominal cramps 37.3% in group I Vs 6% in group II , vaginal bleeding 12.7 in group I Vs 2.7 in group II).  There were no long term complications of the intervention. 

  

Keywords

Human chorionic gonadotrophin; uterine flush; unexplained infertility; intrauterine insemination

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The Impact of Preovulatory Human Chorionic Gonadotrophin Uterine Flushing on Implantation Rate in Women with Unexplained Infertility Scheduled For Intra-Uterine Insemination: A Randomised Prospective Study