Does cervical mucus removal before embryo transfer have an effect on cycle outcome in women undergoing ICSI?: A randomised controlled trial

The objective was to evaluate the effect of cervical mucus removal before embryo transfer on cycle outcome in women undergoing intracytoplasmic sperm injection (ICSI). A total of 183 patients undergoing embryo transfer (ET) with at least one good quality embryo and adequate endometrial thickness and pattern were enrolled to this randomised controlled study. Patients were divided into three groups according to cervical mucus removal technique: removal <i>via</i> cotton swab, removal <i>via</i> Pipella cannula, and a control group with no mucus removal. Data collection included age and body mass index (BMI), duration of infertility, basal hormonal assessments, antral follicle counts, anti-mullerian hormone (AMH) levels, cycle characteristics, and clinical pregnancy rate. There were no significant differences among groups in terms of age, duration of infertility, and basal hormonal levels; in the dosage of gonadotrophins or duration of administration of antagonist; or in the numbers of oocytes retrieved, MII oocytes, fertilised oocytes, and embryos transferred. In terms of the primary outcome measure, all groups had similar clinical pregnancy rates. This study demonstrates that cervical mucus removal prior to ET, regardless of the method used, does not significantly impact clinical pregnancy rates in ICSI cycles. These findings challenge the necessity of routine cervical mucus removal and suggest that this practice may not confer the benefits previously assumed.