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Midluteal single endometrial strip will be taken using a Novak curett under general anasthesia to avoid discomfort and cramping and to proceed to cervical dilatation in case of forbidden cervix, the step that will be beneficial to embryo transfer procedure.
Controller ovarian hyperstimulation; will be done using the long luteal phase agonist protocol and the short protocol(as judged by patient,s age ovarian reserve judged by day 3 FSH and antral follicular count and previous history of ovarian response).
Ovarian response will be monitored by vaginal ultrasound and HCG will be given when when there is >=1 follicle >=18 mm. and >=3 follicles >=16 mm. Ultasound guided oocyte retrieval will be carried out 35 hours later. Embryo transfer will be performed on day 2 or day 3 after oocyt retrieval according to number and quality of embryos.
Embryo transfer will be carried out under trans-abdominal ultrasound guidance pregnancy test will be done using qualitative blood HCG detection 2 weeks after the embryo transfer.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| endometrial scratch injury | Active Comparator | endometrial scratch done before ICSI cycle |
|
| control | No Intervention | IcSI cycle without prior endometrial injury |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endometrial scratch injury | Procedure | midluteal single endometrial strip will be taken using a Novak curett under general anasthesia to avoid discomfort and cramping and to proceed to cervical dilatation in case of forbidden cervix |
| Measure | Description | Time Frame |
|---|---|---|
| implantation rate | number of sacs identifiable through ultrasonography divided by the number of embryos transferred | 14 days after embryo transfer |
| clinical pregnancy rate | the detection of fetal cardiac activity within a gestational sac on ultrasonography examination | 4 weeks after embryo transfer |
| Measure | Description | Time Frame |
|---|---|---|
| multiple pregnancy rate | number of patients who had a multifetal pregnancy divided by the total number of clinical pregnancies | 4 weeks after embryo transfer |
| abortion rate | number of patients who had a spontaneous abortion before 12 weeks of pregnancy divided by total number of clinical pregnancies |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Ahmed Maged | Kasr Alainy medical school | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Kasr Alainy medical school | Cairo | 12151 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29048754 | Derived | Maged AM, Rashwan H, AbdelAziz S, Ramadan W, Mostafa WAI, Metwally AA, Katta M. Randomized controlled trial of the effect of endometrial injury on implantation and clinical pregnancy rates during the first ICSI cycle. Int J Gynaecol Obstet. 2018 Feb;140(2):211-216. doi: 10.1002/ijgo.12355. Epub 2017 Nov 18. |
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| 12 weeks of gestational age |