A new rapid and effective method for treatment of unexplained infertility.
BACKGROUND
Artificial insemination (intrauterine insemination by husband or artificial insemination by husband) is often tried as first treatment for couples with unexplained infertility. Pertubation has previously proved to increase the chance of achieving pregnancy for these couples. The effect of pertubation on fertility can be mechanical as well as anti-inflammatory by using a substance that inhibits phagocytosis of the spermatozoa.The objective of the study was to investigate the effect on pregnancy rate of pre-ovulatory pertubation with low-dose lignocaine during clomiphene citrate and insemination cycles for couples with unexplained infertility.


METHODS
Ina prospective, open study, the patients were randomized, the day before ovulation, during a clomiphene citrate stimulated cycle to either pertubation with low-dose local anaesthetic or no pertubation before insemination.


RESULTS
A total of 130 cycles were studied, 67 of which were randomized to pre-ovulatory pertubation and 63 to no pertubation treatment. There were 14.9% (n 5 10) clinical pregnancies in the pertubated group compared with 3.2% (n 5 2) in the group without pre-ovulatory pertubation (P < 0.05).


CONCLUSIONS
The pertubation treatment significantly enhanced the clinical pregnancy rate and was well tolerated. No complications were noted. The combined treatment of clomiphene citrate, pertubation and insemination can be used as a cost-effective, first-line treatment for couples with unexplained infertility.
Edelstam
Greta
G
Department of Obstetrics and Gynaecology, Karolinska University Hospital, Huddinge, SE-141 86 Stockholm, Sweden. greta.edelstam@karolinska.se
Sjösten
Anette
A
Bjuresten
Kerstin
K
Ek
Ingvar
I
Wånggren
Kjell
K
Spira
Jack
J
D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use*; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use*; D006801:Humans; D007246:Infertility / Q000628:therapy*; D007315:Insemination, Artificial; D008012:Lidocaine / Q000627:therapeutic use*; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D016896:Treatment Outcome
D005300:Fertility Agents, Female; D002996:Clomiphene; D008012:Lidocaine