Effect of Endometrial Injury in Couples With Unexplained Infertility

NCT ID: NCT03398993

Last Updated: 2018-01-16

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-01-31

Study Completion Date

2018-12-31

Brief Summary

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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

Detailed Description

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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

Conditions

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Unexplained Infertility

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Scratch group

Induction of ovulation will be done by clomophine citrate from 3rd day of cycle till 7th day of cycle and HMG 75IU (MerionaL) 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) 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

Group Type ACTIVE_COMPARATOR

Clomiphene Citrate

Intervention Type DRUG

50 mg twice daily from3rd day of cycle till 7th day of cycle

Human chorionic gonadotropin

Intervention Type DRUG

75 IU dail;y from 6th day of cycle till 8th of cycle once daily

Endometrial scratch

Intervention Type DEVICE

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

Non scratch group

They will receive the same induction of ovulation as first group but without performing endometrial injury in preovulatory day

Group Type ACTIVE_COMPARATOR

Clomiphene Citrate

Intervention Type DRUG

50 mg twice daily from3rd day of cycle till 7th day of cycle

Human chorionic gonadotropin

Intervention Type DRUG

75 IU dail;y from 6th day of cycle till 8th of cycle once daily

Interventions

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Clomiphene Citrate

50 mg twice daily from3rd day of cycle till 7th day of cycle

Intervention Type DRUG

Human chorionic gonadotropin

75 IU dail;y from 6th day of cycle till 8th of cycle once daily

Intervention Type DRUG

Endometrial scratch

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

Intervention Type DEVICE

Other Intervention Names

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clomid MerionaL

Eligibility Criteria

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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
Minimum Eligible Age

20 Years

Maximum Eligible Age

36 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Cairo University

OTHER

Sponsor Role lead

Responsible Party

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Ahmed Maged

professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ahmed Maged

Role: PRINCIPAL_INVESTIGATOR

Professor

Locations

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Kasr Alainy medical school

Cairo, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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Ahmed maged

Role: CONTACT

+20201005227404

ameer elsherief

Role: CONTACT

Other Identifiers

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17

Identifier Type: -

Identifier Source: org_study_id

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