Unexplained Infertility Clinical Trial
Official title:
The Effect of Endometrial Scratching by Pipelle on Pregnancy Rate in Couples With Unexplained Infertility
Research question:
Population: women with unexplained infertility. Intervention: endometrial scratching by
pipelle for women with unexplained infertility.
Comparison: to compare with non endometrial scratching for women with unexplained
infertility.
Outcome: the biochemical pregnancy rate.
Research hypothesis:
Null hypothesis: there is no difference in the rate of pregnancy between scratching and non
endometrial scratching in women with unexplained infertility.
Alternative hypothesis: there is difference in the rate of pregnancy between scratching and
non endometrial scratching in women with unexplained infertility.
Unexplained infertility (UI) is a term used to describe infertile couples in whom standard
investigations, including semen analysis, tests of ovulation and tubal patency, have failed
to detect any gross abnormality (Crosignani et al., 1993). It is a diagnosis of exclusion,
almost 30-40% of infertile couples would suffer from this type of subfertility (Simth et
al., 2003). A diversity of causes had been hypothesized to explain the condition. Cervical,
uterine, ovulatory, peritoneal, immunological, endocrinological, genetic defects and
reproductive physiology disturbances had been continuously suggested as potential causative
factors (Rov et al., 2005; Shveiky et al., 2006; Bellver et al., 2008; Golubovsky, 2008;
Woodson, 2008). Empirically, interventions for managing unexplained infertility had been
widely practiced. These interventions include expectant management, intrauterine
insemination (IUI) with ovarian stimulation and in vitro fertilization (El-Toukhy & Khalaf,
2008; Bhattachary et al., 2010).
In humans, the uterus becomes receptive during the midsecretory phase of the menstrual cycle
(days 19-23), commonly known as the window of implantation (WOI). It is assumed that
inadequate uterine receptivity is responsible for approximately two-thirds of implantation
failures (Simon et al., 1998). Since an impairment of endometrial receptivity may be a cause
of subfertility in a group of couples diagnosed with unexplained infertility (Jasper et al.,
2006; Boroujerdnia & Nikbakht, 2008; Konac et al., 2009). Endometrial scratching may help a
group of couples with unexplained infertility.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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