Document Type : Original Article
Authors
1
Department of Obstetrics and Gynecology, Mousavi Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
2
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
3
Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
4
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5
Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran
10.22074/ijfs.2023.2000897.1461
Abstract
Background: The follicular fluid of mature oocytes contains a high concentration of growth factors and cytokines, which all have the potential to influence implantation in either a paracrine or autocrine manner. During the physiological processes of ovulation, follicular fluid enters the fallopian tubes together with the oocyte. The purpose of this study was to evaluate implantation and clinical pregnancy rates following uterine flushing with follicular fluid accompanied by granulosa cells in infertile women with moderate male factor infertility after ovum retrieval for intracytoplasmic sperm injection treatment cycle (ICSI).
Materials and Methods: The study was designed as a randomized controlled trial (ClinicalTrials.gov ID: NCT04077970). One hundred and forty infertile women with moderate male factor infertility who were undergoing ICSI at the Royan Infertility Clinic, Iran, were randomly allocated to one of the following groups using a computer-generated program and opaque sealed envelopes: the case group (n = 70 patients) received 2 ml of clear follicular fluid (without blood contamination) from 2 to 3 dominant follicles after oocyte retrieval. In contrast, only uterine cavity catheterization was performed for women in the control group (n = 70 patients).
Results: The clinical pregnancy rate (38.5% (25/65) vs. 42.9% (27/63); p = 0.71) and implantation rate (24.1% vs. 27%; p = 0.40) did not differ between the group that received follicular fluid and the control group, respectively. Furthermore, there were no statistically significant differences between the intervention and control groups in terms of pregnancy-related complications including ectopic pregnancy, blighted ovum or anembryonic pregnancy, and abortion.
Conclusion: Uterine cavity flushing with follicular fluid from mature follicles following oocyte retrieval had no effect, either positively or negatively, on clinical pregnancy or implantation rates in women with moderate male factor infertility.
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