Effect of Endometrial Injury in Couples With Unexplained Infertility
Effect of Endometrial Injury in Couples With Unexplained Infertility
100 patient of unexplained infertility recruited and divided into two groups for the study
 group (50) endometrial scratching done in preovulatory period after controlled ovarian
 stimulation by clomiphene citrate , then followed and compared to control group for 6 months
 to asses pregnancy rate
Induction of ovulation was done by clomophine citrate (selective estrogen modulator of
 triphenylethylene group, produced by( Sanafi Aventis company) from 3rd day of cycle till 7th
 day of cycle and HMG 75IU (MerionaL) produced by IBSA ( Institute biochimique SA) given from
 6th day of cycle till 8th of cycle once daily. folliculometry done regularly during induction
 of ovulation till dominant follicle reached 18_20mm in size.

 Then endometrial injury performed in pre ovulatory day by a thin pipelle (a fine, flexible,
 sterile, plastic tube) produced by Jiangsu Guard King Medical Equipment Co.

 The procedure was carried out in preovulatory day (known when dominant follicle reached 18_20
 mm in diameter), usually, done around day 14-day of the cycle.

 In the theatre, Patients put in a lithotomy position, sterilization was performed with the
 presence of good source of light., the procedure was carried out using a thin pipelle tube as
 follow :- A cuscoe's speculum was inserted into the vagina in order to visualize the cervix.

 Cervix was grasped by vollselum upwards backwards, then pipelle tube passed through the
 cervix and uterine cavity, then moved up and down to make a single induced scratch two times
 in the lining endometrium of posterior wall of uterus.

 The procedure took approximately 15minutes to complete. It was uncomfortable or painful in
 some circumstances and that bleeding after the procedure happened in many cases. Post
 procedure antibiotics were given.

 Couples were advised to practice timed sexual intercourse for next 6months and couples in
 both groups were asked to phone a contact Person whenever there was a missed period. The
 patients followed up for six months for detecion of the biochemical pregnancy if occurred.

 2- Control group (50patients) :- They received the same induction of ovulation as first group
 but without performing endometrial injury in preovulatory day.

 We wait till time of period if missed period achieved serum pregnancy test done after one
 week of missed period .

 All women followed for 6 months after treatment. Comparative study was done for both groups
 and results presented in tables and statistically analyzed
Inclusion Criteria:

 -  Unexplained infertility ( 1ry & 2ndry infertility) : *

 -  Normal hormonal profile of infertile woman.

 -  Normal hystrosalpingogram.

 -  Normal laparoscopy.

 -  Normal investigation of the cervical factor

 -  Fertile semen analysis (according to world health organization criteria 2015).

 Exclusion Criteria:

 -  • Infertile semen analysis.

 -  Abnormal HSG.

 -  Abnormal laparoscopic findings.

 -  Disturbed hormonal profile.

 -  Evidence of cervical factor.

 -  Known genetic disorder

 -  Known autoimmune disease