Objective: To evaluate the effect of endometrial scratching plus pre transfer flushing of uterine cavity by HCG on clinical pregnancy and implantation rate in casas with previous implantation failure.
Patients & Methods: The study includes 195 infertile ladies with previous
implantation failure. They were randomly divided into three equal groups.
All groups would offered ICSI cycle employing either long GnRH agonist
or the GnRH antagonist protocol according to patient characteristics. In
the first.group, no further intervention was done and in the second group,
endometrial scratch during the luteal phase of the immediate preceding
cycle was employed, while in the third group endometrial scratch plus pre
transfer intrauterine injection of HCG were done.
Results: All variables were expressed as mean + standard deviation In all
studied groups, there were no significant difference as regard their age ,
duration of infertility , body mass index and base line follicle stimulating
hormone as well as base line and peak level of estradiol ( P values > 0.05
.).The biochemical and the clinical as well as the implantation rates were
higher in the endometrial scratch group than in the control group (55.9%
Vs 37.7%, 45.8% Vs 31.1% and 34.9% Vs 21.9% respectively with significant difference, P< 0.05) More increase in the same outcome measures
were noted when comparing the third group with the first group (60% Vs
37.7%, 50% Vs 31.1% and 38.1 Vs 21.9 % respectively, P values< 0.05).
The clinical and implantation rates increase in the third group more than
the second group (45.8% Vs 50% and 34.9% Vs 38.1%) with no statistically significant difference, P> 0.05).
Conclusion: We found that adding pretransfer intrauterine injection of
HCG to endometrial scratch improves the implantation rate in ICSI cycle.