الفهرس | Only 14 pages are availabe for public view |
Abstract Infertility is one of the most common problems among couples worldwide. IVF is the gold standard treatment for causes of infertility, including tubal obstruction, severe male factor, poor ovarian reserve, and unexplained infertility of long duration. RIF is one of the most challenging problems in ART. It is defined as the failure to achieve a pregnancy after transferring high-grade embryos through at least three IVF cycles to the endometrium. There are many different recent modalities in management of RIF. As a result, intrauterine instillation with HGG immediately before embryo transfer has been attempted in order to improve pregnancy rates. Intrauterine infusion of PRP is a new approach that has been suggested for the treatment of thin endometrium. It is used for improving the thickness and vascularity of suboptimal endometria to facilitate embryo implantation. Endometrial scratch, the idea of endometrial injury to improve implantation is based on expression of an acute inflammatory reaction, followed by repair, resulting in the release of cytokines and multiple GFs known to promote implantation. Aim of the work. We aimed to assess and evaluate the effect of intrauterine injection of HGG before embryo transfer of IVF cycle versus intrauterine infusion of autologous platelet rich plasma versus the endometrial scratch on the CPR as a management of the cases who were suffered from unexplained RIF. Methodology. All participants underwent GnRH agonist regimen of induction according to the case, oocytes retrieval, fertilization and embryo transfer). They patients were divided randomly through an enclosed envelop into three different groups, group A (30 cases): the cases in this group had been subjected to instillation of the endometrial cavity with 500IU of HCG. group B (30 cases): the cases were subjected to endometrial scratch or injury. group C (30 cases): the participants in this group were treated by intrauterine infusion of autologous platelet rich plasma (PRP). Results. We founded that there was no statistically differences between the three groups but there were more pregnant woman in the group C using PRP in management of RIF than others. The biochemical pregnancy rates were 30%, 30% and 36.5%, the clinical pregnancy were 23.3% ,20% and 33.3%, and the ongoing pregnancy rates were 20%,13.3%, and 23.3% respectively with group A,B and C. |