부산대학교 도서관

Introduction Infertility is defined as not attaining pregnancy for a year without using contraceptive methods. Infertility treatment is performed according to the cause of infertility. Of course, sometimes the cause [...]
Objective: One of the most common treatments for infertility is intrauterine insemination (II). The objective of this study was to determine the effect of endometrial injury on pregnancy outcomes in unexplained infertility in women undergoing II. Materials and Methods: In this randomized clinical trial, 122 women with unexplained infertility who were referred to Shariati Hospital from 2018 to 2020 were enrolled. They underwent ovulation induction using letrozole and gonadotropins. On day 9 of stimulation, they were randomly assigned to two similar groups of the same size. The first group underwent endometrial local injury by pipelle endometrial sampling, and the second group (control group) received no intervention. Only 1 II cycle was performed for each patient. Patients with negative pregnancy outcomes were followed up for 3 months. Endometrial thickness, dominant follicle count, chemical and clinical pregnancy rate, miscarriage rate, and spontaneous pregnancy rate after the II cycle were compared between the two groups. Results: Endometrial thickness, dominant follicle count, chemical and clinical pregnancy rate, and miscarriage rate in the same II cycle were not different between the two groups (p>0.05). However, the spontaneous pregnancy rate after the II cycle was significantly higher in the endometrial injury group (p=0.02). Conclusion: Endometrial injury increases pregnancy rates in later cycles but not in the same II cycle. Keywords: Endometrium, infertility, intrauterine insemination, pregnancy outcome Amac: Infertilitenin en yaygin tedavi yontemlerinden biri intrauterin inseminasyondur (II). Bu calismanin amaci, II uygulanan kadinlarda aciklanamayan infertilitede endometrial hasarin gebelik sonuclarina etkisini belirlemektir. Gerec ve Yontemler: Bu randomize klinik calismaya, 2018'den 2020'ye kadar Shariati Hastanesi'ne sevk edilen, aciklanamayan infertilitesi olan 122 kadin dahil edildi. Letrozol ve gonadotropinler kullanilarak ovulasyon induksiyonu uygulandi. Hastalar stimulasyonun 9. gununde, ayni buyuklukteki iki benzer gruba rastgele atandilar. Birinci grupta pipelle endometrial ornekleme yoluyla endometriyal lokal hasar olusturuldu, ikinci gruba (kontrol grubu) ise herhangi bir mudahale yapilmadi. Her hastaya sadece 1 II siklusu uygulandi. Gebelik sonuclari olumsuz olan hastalar 3 ay sureyle takip edildi. Iki grup arasinda endometrial kalinlik, baskin folikul sayisi, kimyasal ve klinik gebelik orani, dusuk orani II siklusu sonrasi spontan gebelik orani karsilastirildi. Bulgular: Endometrial kalinlik, baskin folikul sayisi, kimyasal ve klinik gebelik orani ve ayni II siklusunda dusuk orani acisindan iki grup arasinda fark yoktu (p>0,05). Ancak II siklusu sonrasi spontan gebelik orani endometriyal hasarlanma grubunda anlamli olarak daha yuksekti (p=0,02). Sonuc: Endometriyal hasarlanma sonraki sikluslarda gebelik oranlarini artirmaktadir ancak ayni II siklusunda bu durum soz konusu degildir. Anahtar Kelimeler: Endometriyum, infertilite, intrauterin inseminasyon, gebelik sonucu