Objective: to evaluate effect of pre ovulatory saline flushing on pregnancy
rate in patients with ovulatory dysfunction, unexplained infertility, endometriosis and male sub-fertility.
Patients & Methods: the study involved 246 of infertile couples divided
blindly by election into two equal groupseach contain 123; non pertubated
group (A) and saline infusion group (B). Controlledovarian hyper-stimulation by Clomiphene Citrate (100 mg on cycle day 3-7) +HMG (75-150
IU) followed by administration of HCG 5000 IU IM. On the pre-ovulatory
day; when one or two follicles >17mm by TVS, tubal flushing with 20 ml
salinewas carried out in half of the cases (group B).
Results: Patient's demographic data in both groups showed no significant
differences, the mean age was 27.8 ± 7.3 and 26.7 ± 8.1 years respectively.
The mean weight in Kg ± SD was 77.1 ± 9.9 and 79.8 ± 10.3, the mean
height in cm ± SD was 160.5 ± 5.8 and 162.8 ± 7.1 while the duration of
infertility in years was 3.4 ± 1.6 and 3.5 ± 1.1 years respectively. The
number of follicles reached the maturity in both groups showed no significant difference being 4.43 ± 1.7 and 4.67 ±1 respectively while the
overall pregnancy rate was significantly different in both groups (15/123
=12.1% in group A and 29/123 =23.57 % in group B and p-value < 0.001).
Abnormal pregnancies were more or less similar in both groups (multiple
pregnancy, abortion and ectopic occurred in 4,2 and 1 case of the first
while occurred in 5,4 and 1 case of the second group). Finally the live birth
rates was 7.3 % (9/123) in group A and 19.5 % (24/123) with a significant
difference (p value < 0.005).
Conclusion: adding saline flushing to (COH +IUI) cycles can be used as a
cost-effective first line treatment for couples with infertility.