The Effect of LMWH on ICSI in Patients With Unexplained Infertility and Negative Immunological Markers

The Effect of LMWH on ICSI Outcome in Patients With Unexplained Infertility and Negative Immunological Markers; a Randomized Controlled Trial

The purpose of this study is to assess the efficacy of LMWH treatment in women with unexplained infertility and negative immunological markers undergoing ICSI.

Inclusion criteria:

1. patients undergoing 1st trial ICSI
2. unexplained infertility
3. negative immunological markers including ACL abs, LAC, ANA, ATA, AnitdsDNA

Exclusion criteria:

1. previous IVF/ICSI
2. Any cause of infertility
3. Suspected and/or unexpected poor response during ovulation induction
4. positive immunological markers
5. Age > 40 years.

All participants will undergo IVF/ICSI cycle using the Long luteal phase protocol. the dose of gonadotropins will be calculated according to patient age and BMI. All patients will have 2-3 embryos transferred at D5 according to their age. the primary outcome will be LBR. secondary outcomes will include biochemical pregnancy rate and clinical pregnancy rate.

Inclusion Criteria:

• age less than 38 years
• at least 12 months of infertility
• women with unexplained infertility

Exclusion Criteria:

• age more than or equals 38 years
• serum AMH level less than or equals 1 ng/ml
• patients of anticoagulant therapy
• immune-compromised patients
• patients with contraindications to low molecular weight heparin
• positive immunological markers
• patients with other than unexplained infertility
• male factor infertility
• refusal of participation
• patients with unexpected poor or over response during induction of ovulation