Can endometrial injury increase the success of clomiphene citrate in achieving pregnancy?

Aim: The aim of the study is to observe whether endometrial injury has an effect on pregnancy success in patients who are scheduled for timed intercourse

after ovulation induction with the use of clomiphene citrate in patients with unexplained infertility.

Material and Methods: The study was planned as a prospective randomized controlled trial with 215 patients, 105 patients in the injury group and 110

patients in the control group. All patients had unexplained infertility. In the injury group, endometrial injury was performed, before the ovulation induction cycle,

in the mid-luteal phase. No intervention was performed on the patients in the study group before the treatment cycle. Ovulation induction was initiated by

administering 100 mg/day clomiphene citrate and after follicle development, human chorionic gonadotropin (hCG) was administered to the patients in both

groups and timed intercourse (36 hours after hCG) was planned for all patients.

Results: It was observed that 27 (25.7%) patients in the injury group and 19 (17.3%) patients in the control group could achieve pregnancy, 21 (20%) of these

patients in the injury group and 14 (12.7%) patients in the control group were able to achieve clinical pregnancy. As a result, although both pregnancy and

clinical pregnancy rates were found to be increased in the injury group, this increase was not statistically significant.

Discussion: Much larger and more comprehensive studies are needed to show that adding endometrial injury to treatment with clomiphene citrate, which is an

extremely cost-effective and easy procedure, can actually increase pregnancy rates.