الفهرس | Only 14 pages are availabe for public view |
Abstract OBJECTIVE: Investigate the effect of Clopidogrel on pregnancy rate, endometrial thickness and pattern, and ovlation rate in patients with unexplained infertility DESIGN: Prospective randomized study PATIENTS AND METHODS Patients were randomized to two groups: Group(A):(Study group) 64 patients: Induction of ovulation, Clopidogrel and IUI and group (B): (Control group) 64 patients : Induction of ovulation and IUI only, without Clopidogrel Intrauterine insemination was performed 36 - 40 hours after HCG injection. Serum B-subunit HCG was measured 2 weeks after IUI to diagnose pregnancy. Clopidogrel in group (A) was started from menstrual day 1, all through the cycle 75mg per day till performing quantitative BHCG titer. Ain Shams university Fetal medicine and Ultrasound Unit .Transvaginal sonograhhy was done using a transvaginal transducer with color Doppler facility.On the day of IUI , Transvaginal sonography was performed. The endometrial thickness, pattern and vascular thickness and pattern, vascular impedance of the uterine artery and Subendometrial blood vessles (pulsatility index and resistance index) and ovarian dominant follicle. RESULTS: The pregnancy rate was slightly higher in the study group receiving Clopidogrel compared to the control group. The Trilaminar endometrial pattern, which is more favourable for implantation, was significantly higher in the Clopidogrel group(79.7%) compared to the control group(31.3%). The endometrial thickness showed statistical significance between the two groups. It was higher in the Clopidogrel group compared to the study group. CONCLUSION: Overall, the results of this randomized double-blind study showed that in women with unexplained infertility undergoing IUI, Clopidogrel, when started concomitantly with controlled ovarian stimulation, did not affect uterine artery vascular impedance on the day of IUI and also did not increase pregnancy rate or affect ovulation. This could be due to the small sample size of this study However, it improved subendometrial blood flow as well as endometrial thickness and endometrial pattern which would be more favorable for implantation. |