Prospective randomized study for hydrotubation with or without lidocaine before intrauterine insemination in unexplained infertility

Objective: To investigate the therapeutic yield of hydrotubation using low-dose lidocaine conducted one-day before intrauterine insemination (IUI) in stimulated cycles for couples with unexplained infertility. Design: Prospective randomized controlled trial. Patients and methods: Two hundred and nineteen women with unexplained infertility were scheduled randomly for hydrotubation either with saline (109 patients) or low dose Lidocaine in saline (110 patients). Hydrotubation was carried on one-day before intrauterine insemination in clomiphene citrate stimulated cycle. Outcome measures were rates of pregnancy, first trimester abortion, ectopic pregnancy, multiple pregnancy, and ovarian hyperstimulation syndrome, and procedure related pain. Results: Lidocaine group had higher clinical pregnancy rates when compared with saline group with no significant difference (17.43% vs 11.2%, respectively; p= 0.193). There were no statistical significant differences as regards the rates of multiple pregnancy, first trimester abortion, and ectopic pregnancy between both groups. No ovarian hyperstimulation syndrome occurred in either group. Using the visual analog score, patients in both groups felt mild to moderate pains without significant differences in frequencies of pain intensity in both groups. Conclusion: Hydrotubation with low dose Lidocaine in saline one day before IUI allowed a nonsignificant higher pregnancy rate when compared to saline alone in couples with unexplained infertility. (C) 2012 Middle East Fertility Society. Production and hosting by Elsevier B.V. All rights reserved.