title: Improvement in pregnancy rate by removal of cervical discharge prior to embryo transfer in ICSI cycles: a randomised clinical trial.
abstract: OBJECTIVE
  The present study aimed to evaluate the effect of removing cervical discharge prior to embryo transfer (ET) on pregnancy rates.
  
  
  METHODS
  Five hundred and thirty women who were candidates for fresh ET in intracytoplasmic sperm injection (ICSI) cycles were randomly allocated to intervention or control groups. In the intervention group, the cervical canal was cleansed using sterile cotton swabs prior to ET. The control group had routine ET. Multiple logistic regression analysis was used to estimate the adjusted effect of removing the cervical discharge on pregnancy rates.
  
  
  RESULTS
  There was a significant difference in pregnancy rates between the two groups. The clinical pregnancy rate was 104/265 (39.2%) in the intervention group compared with 60/265 (22.6%) in the control group (P<0.001). The intervention group also had a higher implantation rate (20.5%) compared with the control group (12.2%; P<0.001). Additionally, the live birth rate in the intervention group (33.6%) was significantly higher than in the control group (17.4%; P<0.001). The logistic regression analysis indicated that the odds ratio of pregnancy in the intervention group was 2.297 (95% CI, 1.552-3.399) compared with the control group.
  
  
  CONCLUSIONS
  Removal of cervical discharge prior to ET may have a significant effect on the rate of implantation, pregnancy and live birth.
authors.affiliation: Department of Endocrinology and Female Infertility, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Moini
authors.forename: Kiandokht
authors.initials: K
authors.lastname: Kiani
authors.forename: Akram
authors.initials: A
authors.lastname: Bahmanabadi
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Akhoond
authors.forename: Aliasghar
authors.initials: A
authors.lastname: Akhlaghi
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer / Q000379:methods*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D016037:Single-Blind Method; D020554:Sperm Injections, Intracytoplasmic; D019522:Vaginal Discharge