Endometrial scratching for women with previous IVF failure undergoing IVF treatment

Abstract

The purpose of this study was to find out whether endometrial scratching could improve live birth rate in women with previous IVF failure undergoing fresh IVF cycle. In a randomized controlled trial, 387 women with previous IVF failure were divided into two groups. Group A (193 women) was subjected to endometrial biopsy procedure twice. Group B (194 women) was subjected to a placebo procedure. Our results showed no difference in live birth rate between the two groups of women (47.2% versus 38.1%, p = 0.08). However, regression analysis revealed that endometrial scratching was an independent predictor of live birth in the subgroup of women with two or more previous failure after control of other independent predictors (odds ratio (OR) 3.4, p = 0.005). We conclude that endometrial scratching does not improve live birth rate in women undergoing IVF treatment with previous one IVF failure. Nevertheless, it may improve live birth in women with two or more previous IVF failures.

Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure?

“…We interpreted these results as an increase of endometrial receptivity by endometrial scratching while the other parameters influencing implantation process such as quality of oocyte and transferred embryos were similar between the groups. The majority of literature regarding endometrial injury suggested favorable implantation and clinical pregnancy rates [1,[7][8][9][10][11][12][13][14].…”

Endometrial injury prior to assisted reproductive techniques for recurrent implantation failure: a systematic literature review

“…Added to this, some of the studies were themselves inconsistent, with design aspects that potentially biased the result such as the use of sham procedures in the control group, which could have led to unintentional endometrial injury. This was highlighted in the recently updated Cochrane systematic review [36] that includes data from the subgroup of patients with recurrent implantation failure undergoing ART from the recently published RCT by Gibreel et al [33]. Even though the updated Cochrane systematic review showed a potential positive effect of endometrial injury on live birth rates for women with recurrent implantation failure undergoing ART, it highlighted that several uncertainties remain and called for further research to confirm this observation.…”

“…Initial data from more than 300 references (mainly case reports, case series, case-controlled studies and expert opinions), 5 RCTs [29][30][31][32][33] and 3 meta-analyses [34][35][36], which observed that endometrial injury improves the main reproductive outcomes in unselected women undergoing ART, have been encouraging leading to early adoption of this procedure by many reproductive units. However, evidence was either largely observational and unreliable or derived from population groups with different characteristics to women with recurrent implantation failure.…”

Chronic endometritis and infertility

“…Some studies have proposed that endometrial scratching or injury, as is involved in diagnostic hysteroscopy, could increase the implantation rate and the clinical pregnancy rate in women with previous IVF-ET failures [808182838485]. The hypothetical biological basis for this proposal is as follows [86].…”