Improving reproductive outcomes of intrauterine insemination: Does endometrial scratch injury help? A randomised controlled trial

Ghuman, Navdeep Kaur; Raikar, Sunil; Singh, Pratibha; Gothwal, Meenakshi; Yadav, Garima

doi:10.1016/j.ejogrb.2020.08.010

Cited by 7 publications

(5 citation statements)

References 33 publications

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“…Patients who received the Pipelle in our study reported a pain score of 3.9, which is congruent with findings from a prior large-scale study that found a median pain score of 3.5 on a visual analog scale among patients who underwent endometrial scratch using the Pipelle (13). While additional studies of endometrial scratch reported pain scores of 6.42 and 6.93, these discrepancies may be due to several factors including differences in ART cycle characteristics, pre-procedure preparations and variability in clinician technique (11,12). For instance, all patients in the Nastri, Ferriani (11) study received oral contraceptive pretreatment and the majority of these patients had 2 or more unsuccessful embryo transfers, which may contribute to higher patient-reported pain scores.…”

Section: Discussionsupporting

confidence: 82%

“…In a multicenter randomized control trial of 1,364 patients, the median pain score reported by patients who underwent endometrial scratch was 3.5 out of 10 on a visual analogue scale (IQR=1.9-6.0) (Lensen, 2019). Furthermore, two additional studies found patients who underwent endometrial scratch experienced moderate to severe pain with mean pain scores of 6.42 and 6.93 (11,12). However, these studies utilized the Pipelle catheter for endometrial biopsy.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Two Types of Endometrial Scratch before Embryo Transfer and Patient-Reported Pain Scores: A Prospective Randomized Pilot Study

S Hurst

2024

JOGRS

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Background: The impact of various methods of endometrial scratch during assisted reproductive technology (ART) is not well established. Objective: To compare patient-reported pain scores and ART outcomes following two types of endometrial scratch prior to embryo transfer. Study design: In this prospective, non-blinded, randomized controlled trial, patients were assigned to either Pipelle or Shepard catheter. The primary outcome was mean pain score. Secondary outcomes included implantation rate (IR) and clinical pregnancy rate (CPR). Results: One hundred seventy transfers were included (Pipelle: n=78, Shepard: n=92). Mean pain scores were significantly lower in the Shepard group compared to the Pipelle group (3.0±2.4 vs. 3.9±2.2, respectively; p=0.01). There was no significant difference in IR (Shepard: 59.7%±52 and Pipelle: 56.5%±48; p=0.9) and CPR (Shepard: 67.6%±47 and Pipelle: 71.8%±45; p=0.6). Conclusions: In our study, the Shepard catheter was a less painful method of endometrial scratch without compromising ART outcomes.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Comparison of Two Types of Endometrial Scratch before Embryo Transfer and Patient-Reported Pain Scores: A Prospective Randomized Pilot Study

S Hurst

2024

JOGRS

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“…Then, we also noticed that the timing of endometrial injury may also have an impact on pregnancy outcomes. In 2020, data showed that there was insufficient evidence to support the use of endometrial injury in the follicular phase in intrauterine insemination treatment cycles ( 17 ). Another RCT demonstrated that endometrial injury in the luteal phase before ovarian stimulation significantly enhanced the clinical pregnancy rate in women with three or more prior implantation failures ( 18 ).…”

Section: Discussionmentioning

confidence: 99%

Comparing the effects of endometrial injury in the luteal phase and follicular phase on in vitro fertilization treatment outcomes

Wang

Bu²,

Hu³

2022

Front. Endocrinol.

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BackgroundSeveral studies have shown that endometrial injury improves clinical pregnancy outcomes in patients undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment with a history of implantation failure. However, endometrial injury can be performed in the follicular phase (FP) followed by embryo transfer in the same menstrual cycle or in the luteal phase (LP) before the embryo transfer cycle.MethodThis prospective cohort study was conducted from January 2015 to September 2021, and a total of 487 patients were included. All included patients had a history of a failed implantation cycle. They were divided into two groups: the FP group (N = 330), in which endometrial injury was performed on menstrual day 3-5, and the LP group (N = 157), in which endometrial injury was performed in the cycle preceding embryo transfer 7 days after ovulation.ResultsFirst, in unselected patients, the implantation rate and clinical pregnancy rate were comparable between the LP and FP groups. However, in patients with a history of ≥ 2 failed transfer cycles, the implantation rate was significantly higher in the LP group than in FP group (43.09% versus 33.33%, P = 0.03). Moreover, the clinical pregnancy rate was also significantly higher in patients in the LP group than in patients in the FP group (60.17% versus 46.15%, P=0.02). In addition, logistic regression analysis showed that endometrial injury in the LP group was an independent factor affecting clinical pregnancy outcome in patients with a history of ≥ 2 failed transfer cycles (aOR = 2.05, 90% CI:1.22-3.47, P=0.01).ConclusionEndometrial injury improves pregnancy outcomes when performed in the luteal phase compared with the follicular phase in patients with a history of ≥ 2 failed transfer cycles but not in unselected patients.

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“…Twenty-five studies included 4234 women fulfilled the inclusion criteria, five of them (774 women) assessed the outcomes in natural cycles [12][13][14][15][16] and 20 studies (3460 women) assessed the outcomes in IUI cycles. [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] All the studies were conducted in single centers except three studies that were conducted in two centers. 12,17,25 Eleven studies were carried out in Egypt, six in India, six in Iran, one in United Arab of Emirates and one in Turkey.…”

Section: Study Selection Study Characteristicsmentioning

confidence: 99%

“…12,17,25 Eleven studies were carried out in Egypt, six in India, six in Iran, one in United Arab of Emirates and one in Turkey. Among the studies, only three studies were prospectively registered, 13,22,33 eight were not registered at all 14,19,20,26,27,29,34,36 and the remaining 14 studies were retrospectively registered.…”

Section: Study Selection Study Characteristicsmentioning

confidence: 99%

Retracted: Endometrial scratch injury in infertile women seeking conception through natural or intrauterine insemination cycles: A systematic review and meta‐analysis

Maged

Ogila

Mohsen

et al. 2021

Intl J Gynecology & Obste

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Improving reproductive outcomes of intrauterine insemination: Does endometrial scratch injury help? A randomised controlled trial

Cited by 7 publications

References 33 publications

Comparison of Two Types of Endometrial Scratch before Embryo Transfer and Patient-Reported Pain Scores: A Prospective Randomized Pilot Study

Comparison of Two Types of Endometrial Scratch before Embryo Transfer and Patient-Reported Pain Scores: A Prospective Randomized Pilot Study

Comparing the effects of endometrial injury in the luteal phase and follicular phase on in vitro fertilization treatment outcomes

Retracted: Endometrial scratch injury in infertile women seeking conception through natural or intrauterine insemination cycles: A systematic review and meta‐analysis

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