Endometrial receptivity and implantation in women with previous failed embryo transfers: to scratch or not to scratch?

Galliano, Daniela

doi:10.1016/j.fertnstert.2019.09.008

Cited by 2 publications

(3 citation statements)

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“…Since the first study on ES published by Barash et al in 2003 [35], several RCTs have failed to give a definitive answer to the question whether ES may im-prove the IVF outcome in specific IVF subpopulations [36][37][38]. Waiting for further well-done clarifying studies [1], we agree [32] to recommend to our patients that their financial resources are better saved for additional cycles of evidence-based treatments at lower costs instead of inflating the costs of a single cycle.…”

Section: Discussionmentioning

confidence: 99%

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Fertility specialists’ views, behavior, and attitudes towards the use of endometrial scratching in Italy

Palomba,

Carone,

Vitagliano

et al. 2023

BMC Women's Health

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Background Endometrial scratching (ES) or injury is intentional damage to the endometrium performed to improve reproductive outcomes for infertile women desiring pregnancy. Moreover, recent systematic reviews with meta-analyses and randomized controlled trials demonstrated that ES is not effective, data on the safety are limited, and it should not be recommended in clinical practice. The aim of the current study was to assess the view and behavior towards ES among fertility specialists throughout infertility centers in Italy, and the relationship between these views and the attitudes towards the use of ES as an add-on in their commercial setting. Methods Online survey among infertility centers, affiliated to Italian Society of Human Reproduction (SIRU), was performed using a detailed questionnaire including 45 questions with the possibility to give “closed” multi-choice answers for 41 items and “open” answers for 4 items. Online data from the websites of the infertility centers resulting in affiliation with the specialists were also recorded and analyzed. The quality of information about ES given on infertility centers websites was assessed using a scoring matrix including 10 specific questions (scored from 0 to 2 points), and the possible scores ranged from 0 to 13 points (‘excellent’ if the score was 9 points or more, ‘moderate’ if the score was between 5 and 8, and ‘poor’ if it was 4 points or less). Results The response rate was of 60.6% (43 questionnaires / 71 infertility SIRU-affiliated centers). All included questionnaires were completed in their entirety. Most physicians (~ 70%) reported to offer ES to less than 10% of their patients. The procedure is mainly performed in the secretory phase (69.2%) using pipelle (61.5%), and usually in medical ambulatory (56.4%) before IVF cycles to improve implantation (71.8%) without drugs administration (e.g., pain drugs, antibiotics, anti-hemorrhagics, or others) before (76.8%) or after (64.1%) the procedure. Only a little proportion of infertility centers included in the analysis proposes formally the ES as an add-on procedure (9.3%), even if, when proposed, the full description of the indications, efficacy, safety, and costs is never addressed. However, the overall information quality of the websites was generally “poor” ranging from 3 to 8 and having a low total score (4.7 ± 1.6; mean ± standard deviation). Conclusions In Italy, ES is a procedure still performed among fertility specialists for improving the implantation rate in IVF patients. Moreover, they have a poor attitude in proposing ES as an add-on in the commercial setting.

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Section: Discussionmentioning

confidence: 99%

“…36 Poliambulatorio Teatro Nuovo, Vicenza, Italy. 37 Clinica Nuova Ricerca, Rimini, Italy. 38 • thorough peer review by experienced researchers in your field…”

Section: Abbreviationsmentioning

confidence: 99%

Fertility specialists’ views, behavior, and attitudes towards the use of endometrial scratching in Italy

Palomba,

Carone,

Vitagliano

et al. 2023

BMC Women's Health

View full text Add to dashboard Cite

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“…While ES was considered controversial ever since it was first published in 2003 [7] the controversies regarding ES intensified following recent publications in leading journals, including a publication in the NEJM, which showed that the procedure was not efficacious [11]. The above paper was then followed by a series of debates [31,33,34], raising further the level of controversy. These papers were, to a large extent, the force driving the conduction of our survey, in an attempt to assess the impact of recent publications on the scientific community.…”

Section: Discussionmentioning

confidence: 99%

Use of Endometrial Scratching in IVF/IUI – A Worldwide Opinion and Clinical Practice Survey

Shoham¹,

Alexandroni²,

Leong³

et al. 2022

Clin. Exp. Obstet. Gynecol.

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Background: Following recent publications regarding the use of the controversial procedure, endometrial scratching (ES), we wish to gain insights into in vitro fertilization (IVF) clinicians' knowledge and practice, including an updated literature review, current versus past utilization, patient selection, timing and frequency. Methods: Internet-based self-report multiple-choice/multiple-answer survey of IVF clinics. Results: Of the 143 IVF units completing the survey, 119 have used ES in IVF/intrauterine insemination (IUI). Of the respondents with ES experience, 94% recommended ES to patients with repeated implantation failure, 32.3% to patients with a thin endometrium, and 3.5% to general IVF/IUI patients. The majority of respondents performed ES only once prior to an IVF cycle. Of current or past ES users, 73% stopped or reduced ES frequency after reading recent ES-related publications. This was despite the finding that 57.2% believed that ES increased implantation and live-birth likelihood in selected IVF/IUI patients. Conclusions: Despite previous widespread utilization of ES, the lack of consensus regarding patient selection, timing, and benefits of the procedure, has prompted many IVF clinicians who used the procedure in the past to abandon the intervention. According to our study, ES is practiced most commonly for patients with repeated implantation failure and performed once during the luteal phase. Further research is needed to obtain definitive practice guidelines based on ES successes and failures-specifically a prospective randomized controlled study according to the methodology used by Barash et al., original publication.

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Endometrial receptivity and implantation in women with previous failed embryo transfers: to scratch or not to scratch?

Cited by 2 publications

References 4 publications

Fertility specialists’ views, behavior, and attitudes towards the use of endometrial scratching in Italy

Fertility specialists’ views, behavior, and attitudes towards the use of endometrial scratching in Italy

Use of Endometrial Scratching in IVF/IUI – A Worldwide Opinion and Clinical Practice Survey

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