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Aspiration with Diosmin Intake in Endometrial Cavity Fluid Accumulation in ART Cycles: A Randomized Controlled Trial

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Abstract

Background

This was a prospective randomized controlled trial in 200 cases presented with endometrial cavity fluid at the day of oocyte retrieval at a private fertility center from 2013 to 2021. The cases were randomized at day of ovum pickup into 2 groups: Group 1 (control group) (n = 100): conventional management with follow-up and reassessment by transvaginal ultrasound on day 5. Group 2 (interventional group) (n = 100): aspiration of the fluid was done and cases were given diosmin 500 mg 3 times per day till reassessment at embryo transfer day. In both groups, we proceeded with fresh embryo transfer if no fluid is present on day 5 or freeze-all policy if persistent fluid was detected.

Results

Endometrial fluid on the 5th day was significantly higher in the control group (28.0%) than in the interventional group (6.0%) (P < 0.001). Regarding pregnancy rate, although being higher in the interventional group (54.3% vs 50.0%), the difference was not statistically significant (P = 0.5). It was found that the intervention was associated with risk reduction of endometrial fluid (OR = 0.168, 95% CI = 0.065–0.429, P < 0.001.

Conclusion

Aspiration of endometrial cavity fluid with diosmin intake increased the likelihood of fresh embryo transfer and with a slightly better pregnancy rate compared to conservative management.

Clinical trial number: NCT02158000, Date of registration: 6/6/2014, Date of initial enrollment (first patient recruiting): 1/11/2014, URL: https://clinicaltrials.gov/ct2/show/NCT02158000.

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Acknowledgements

We would like to thank our dedicated lab directors. Dr. Waleed Abdel lateef & Dr. Sahar Eissa for their continuous support.

Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Obstetrics and Gynecology Department, Faculty of Medicine, Hawaa Fertility Center, Benha University, Benha, 13512, Egypt

    Ahmed Samy Saad & Khalid Abd Aziz Mohamed

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Contributions

The authors have explained the intervention to the patients and had their consent. No personal information of the patients or details have been revealed. The authors have equally contributed in collecting the data and writing the research work.

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Correspondence to Khalid Abd Aziz Mohamed.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics Approval and Consent to Participate

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: The study was approved by the institutional review board of the fertility center (Hawaa—001-0056) at 5/6/2013. All procedures performed in this study involving human participants were in accordance with the Declaration of Helsinki (as revised in 2013).

Informed Consent

The authors have explained the intervention to the patients and had their written consent and no personal information of the patients or details have been revealed.

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Ahmed Samy Saad is an Assistant Professor; Khalid Abd Aziz Mohamed is an Assistant Professor.

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Saad, A.S., Mohamed, K.A.A. Aspiration with Diosmin Intake in Endometrial Cavity Fluid Accumulation in ART Cycles: A Randomized Controlled Trial. J Obstet Gynecol India 73, 336–342 (2023). https://doi.org/10.1007/s13224-023-01791-7

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