{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:17:58Z","timestamp":1767165478247,"version":"build-2238731810"},"reference-count":31,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T00:00:00Z","timestamp":1512691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To detect if removing the cervical mucus before performing intrauterine insemination (\n                      <jats:styled-content style=\"fixed-case\">IUI<\/jats:styled-content>\n                      ) could improve pregnancy outcomes in patients with unexplained infertility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective randomized study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>An Egyptian University Hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>\n                      Seven hundred and fourteen couples with unexplained infertility who underwent intrauterine insemination (\n                      <jats:styled-content style=\"fixed-case\">IUI<\/jats:styled-content>\n                      ) with or without cervical mucus removal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using computer\u2010generated numbers, patients were randomly allocated to cervical\u2010mucus\u2010removal (removed from both internal and external os) or non\u2010mucus\u2010removal groups. Only participants were blinded as to group assignment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>The clinical pregnancy rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 714\n                      <jats:styled-content style=\"fixed-case\">IUI<\/jats:styled-content>\n                      patients between November 2014 and March 2017, 361 were in the mucus removal group, and 353 in the non\u2010mucus\u2010removal group. Difficult catheterization was encountered in 17 cases out of 666 (2.6%) 12 in the cervical\u2010mucus\u2010removal group and five in the non\u2010mucus\u2010removal group). A total of 666\n                      <jats:styled-content style=\"fixed-case\">IUI<\/jats:styled-content>\n                      cycles were completed while 48 were either cancelled or lost in their follow\u2010up. The clinical pregnancy rate was significantly higher in the mucus\u2010removal group [31.0% (\n                      <jats:italic>n =<\/jats:italic>\n                      112)] than in the non\u2010mucus\u2010removal group [21.8% (\n                      <jats:italic>n<\/jats:italic>\n                      = 77);\n                      <jats:italic>P<\/jats:italic>\n                      = 0.005]. Ovarian hyperstimulation developed in 33 (4.6%) cases: 18 cervical mucus\u2010removal and 15 non\u2010mucus\u2010removal. All except one were mild and managed with outpatient care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Cervical mucus removal before\n                      <jats:styled-content style=\"fixed-case\">IUI<\/jats:styled-content>\n                      could improve pregnancy outcomes in women with unexplained infertility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Tweetable abstract<\/jats:title>\n                    <jats:p>\n                      Cervical mucus removal before\n                      <jats:styled-content style=\"fixed-case\">IUI<\/jats:styled-content>\n                      can improve pregnancy outcomes.\n                    <\/jats:p>\n                  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