The Effect of Single Endometrial Curettage on Pregnancy Rate in Unexplained Infertility in Primary Care Setting

Aims: To examine the effect of single endometrial curettage (EC), performed during the menstrual period in primary clinical care setting, on pregnancy rate (PR) in women with unexplained infertility and subgroup analysis based on age and primary and secondary infertility.
Study Design: Randomized controlled clinical study.
Place and Duration of Study: Private practice setting, Baghdad, between February 2009 and January 2012.
Methodology: A total of 197 couples aged 20-40 years with unexplained infertility were randomly allocated into two groups: group A comprised 110 women who underwent EC during the menstrual period; and group B included 87 women, who represent the control group, with no EC done. Both groups received no further fertility treatment. The main outcome measured was cumulative clinical (PR) during 6 months after the endometrial curettage.
Results: PR was higher in control group compared to EC group (48.3% vs. 45.5%), and in secondary infertility in women aged 31-40 years (75% vs. 58.8%), and in primary infertility in women aged 20-30 years (35% vs. 5.4%) and 31-40 years (25% vs. 5.5%).
Conclusion: EC may improve PR in couples with primary unexplained infertility independent of the age group, and in secondary infertility age group 31-40 years. Adequately powered studies are suggested to confirm or refute the findings.