The effect of endometrial injury on first cycle IVF/ICSI outcome: A randomized controlled trial

Mahran, Ahmad; Ibrahim, Mahmoud A. A.; Bahaa, Haitham Ahmed

doi:10.29252/ijrm.14.3.193

Cited by 30 publications

(142 citation statements)

References 13 publications

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“…The risk of bias of the included RCTs is described in Table II. For seven RCTs, the risk of selection bias was unclear because the method of allocation was not clearly described (Karimzadeh et al , 2009; Baum et al , 2012; Inal et al , 2012; Singh et al , 2015; Mahran et al , 2016; Liu et al , 2017; Maged et al , 2018). Random sequence generation was interpreted to be at a low risk of selection bias because this was performed by computer-generated sequence (Narvekar et al , 2010; Safdarian et al , 2011; Inal et al , 2012; Nastri et al , 2013; Yeung et al , 2014; Gibreel et al , 2015; Singh et al , 2015; Tk et al , 2017; Maged et al , 2018), a table of random numbers (Baum et al , 2012; Liu et al , 2017), sealed envelopes (Mahran et al , 2016) or a bag of papers with equal amounts of intervention and control groups (Karimzadeh et al , 2009).…”

Section: Resultsmentioning

confidence: 99%

“…Since the publication of the abovementioned reviews, multiple RCTs on endometrial injury prior to ART have been carried out. While the first trials mainly focused on patients with RIF, more recent studies have shifted their focus to also include patients in earlier stages of IVF/ICSI treatment (Mahran et al , 2016; Liu et al , 2017; Tk et al , 2017; Maged et al , 2018). The increase in number of published studies not only calls for an updated review of the existing body of evidence, but also has created the possibility to subgroup patients according to the number of failed IVF/ICSI cycles.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis

Hoogenhuijze

Kasius²,

Broekmans

et al. 2019

Human Reproduction Open

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STUDY QUESTION What is the effect of endometrial scratching in patients with or without prior failed ART cycles on live birth (LBR) and clinical pregnancy rates (CPR)? SUMMARY ANSWER It remains unclear if endometrial scratching improves the chance of pregnancy and, if so, for whom. WHAT IS KNOWN ALREADY Endometrial scratching is hypothesized to improve embryo implantation in ART. Multiple studies have been published, but it remains unclear if endometrial scratching actually improves pregnancy rates and, if so, for which patients. STUDY DESIGN, SIZE, DURATION For this review, a systematic search for published articles on endometrial scratching and ART was performed on 12 February 2018, in Pubmed, Embase and the Cochrane Library. PARTICIPANTS/MATERIALS, SETTING, METHODS Randomized controlled trials (RCTs) that evaluated endometrial scratching in the cycle prior to the stimulation cycle and reported CPR or LBR were included. RCTs investigating the effect of scratching during the stimulation cycle, or prior to cryo-thaw cycles were excluded. Studies were assessed using the Cochrane Risk of Bias tool. The effect of scratching was assessed for three different patient groups: patients with no prior IVF/ICSI treatment (Group 0), patients with one failed full IVF/ICSI cycle, including cryo-thaw cycles (Group 1) and patients with two or more failed full IVF/ICSI cycles (Group 2). A meta-analysis was performed when statistical heterogeneity was low; otherwise, a descriptive analysis was performed. MAIN RESULTS AND THE ROLE OF CHANCE Fourteen RCTs involving 2537 participants were included. Most RCTs contained a high or unclear risk of bias on one or more items. Substantial clinical and statistical heterogeneity was present; therefore meta-analysis for LBR and CPR could only be performed on Group 1. For this group, no differences between scratch and control were found for both LBR (risk ratio (RR) 1.01 [95%CI 0.68–1.51]) and CPR (RR 1.04 [95%CI 0.74–1.45]). For Groups 0 and 2, pooled analysis could not be performed, and for both groups the results of the individual RCTs were negative, neutral and positive. Miscarriage and multiple pregnancy rates were evaluated for the three groups (0, 1 and 2) together. Both outcomes were not significantly different between scratch and control (miscarriage rate RR 0.82 [95%CI 0.57–1.17] and multiple pregnancy rate RR 1.06 [95%CI 0.84–1.35]). Subgroup analysis, excluding trials with a risk of unintentional endometrial injury in the control group, was performed for Group 0 and 2 for LBR and CPR, and for the overall groups for miscarriage rate and multiple pregnancy rate. This reduced the heterogeneity and allowed for pooled analysis in these subgroups. Results of pooled analysis for the subgroups of Group 0 and 2 showed no significant difference for LBR, but CPR was significantly improved after endometrial scratchin...

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis

Hoogenhuijze

Kasius²,

Broekmans

et al. 2019

Human Reproduction Open

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“…However, the most recent systematic review has reported no effect of the procedure on women undergoing IVF treatment with a previous one failed IVF cycle [23]. However, there is still uncertainty about the value of the procedure in women undergoing it for the first time [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Endometrial scratch for infertile polycystic ovary syndrome (PCOS) women undergoing laparoscopic ovarian drilling: a randomized controlled trial

Gibreel

Ali

Hemida

et al. 2019

Middle East Fertil Soc J

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Background: Women with polycystic ovarian syndrome (PCOS) may undergo laparoscopic ovarian drilling (LOD). To find out whether endometrial scratch, at time of LOD, could improve live birth rate in subfertile women with PCOS, a randomized controlled trial was conducted. Results: There was no evidence of a significant difference in cumulative live birth rate between women who had endometrial scratch at time of LOD and those who had LOD only (38.1% and 34.3% respectively, odds ratio 1.18, 95% CI (0.67, 2.07); p = 0.57). Conclusion: Women undergoing laparoscopic ovarian drilling should not be subjected to endometrial scratch as it does not lead to improvement in live birth rate. The study was prospectively registered on 25 April 2014 in ClinicalTrials.gov with identifier number NCT02140398. Patients and methods Study design and participants We conducted a parallel randomized controlled trial (RCT), approved by our university ethics committee. We approached all infertile women with anovulatory infertility due to PCOS referred for laparoscopic ovarian drilling in Mansoura University Teaching Hospitals in Mansoura,

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“…Live birth and implantation rates were significantly lower in the control group than the study group (67% vs 28%, and 22.4% vs 18%, respectively). 16 In 2014, Yeung et al, evaluated 209 sub-fertile women with the first IVF-ET cycle, who underwent LEI with a biopsy catheter in the luteal phase preceding the IVF-ET cycle and no difference was reported in ongoing pregnancy rates of the study and control groups. 17 In these two studies, unlike our study, LEI was induced by a biopsy catheter in the luteal phase of the menstrual cycle.…”

Section: Discussionmentioning

confidence: 99%

Is There any Impact of Local Endometrial Injury on Implantation and Clinical Pregnancy Rates in the First in Vitro Fertilization Cycles

Cüylan¹,

Demır²,

Dilbaz³

et al. 2019

JCOG

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mplantation is one of the most crucial steps for a successful in-vitro fertilization (IVF)-embryo transfer (ET). Implantation success depends on the quality of the embryo and endometrial receptivity. Even with a good quality embryo transfer, the rates of implantation may vary between 25-30% per transferred embryo. 1,2 Implantation occurs during the "implantation window", which is the period between the 19 th and 23 rd days of the menstrual cycle, when endometrial receptivity is at its peak, and includes a three-stage process of apposition, adhesion and invasion of the blastocyst to the endometrium.Recently, local endometrial injury (LEI) has been proposed as one of the methods that aim to increase the implantation rates in IVF-ET cycles. Initially, Barash et al. showed an increase in implantation and pregnancy rates in 134 women who had repeated endometrial biopsies as a method of LEI before IVF-ET cycles. 3 Likewise, other studies have also demonstrated an increase in pregnancy rates after LEI in women with recurrent IVF failure. 4,5 The first study investigating the effect of LEI on implantation and JCOG. 2019;29(4):129-35 129 A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : To evaluate the impact of local endometrial injury (LEI), applied during the first in vitro fertilization (IVF)-embryo transfer (ET) cycle using office hysteroscopy, on implantation and pregnancy rates. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : A total of 372 women under the age of 40, who had their first IVF-ET treatment cycle, with no ovulatory or intracavitary pathology were included in this study. LEI was created in the fundus, anterior and posterior endometrial walls during office hysteroscopy, which was performed prior to the IVF-ET cycle. Long luteal gonadotropin releasing hormone agonist protocol was used in all cycles and 273 patients underwent embryo transfer. Implantation and pregnancy rates were compared to the control group. R Re es su ul lt ts s: : Age, body mass index, baseline follicle stimulating hormone, luteinizing hormone, and estradiol levels, antral follicle counts, infertility etiologies, total oocyte counts, intra-cytoplasmic sperm injection percentages were similar, both in the study and the control groups. Clinical pregnancy rates (28.7% vs 26.1%, p>0.05), total pregnancy rates (43.1% vs 38%, p>0.05) and implantation rates (19% vs 12.9%, p>0.05) of the LEI injury group were higher than those of the control group, however the difference was not statistically significant. There was no statistically significant difference between the miscarriage rates. C Co on nc cl lu us si io on n: : Even if implantation and pregnancy rates improved slightly in LEI group, the study did not reveal a significant improvement for the implantation and pregnancy rates after the LEI, which was created during hysteroscopy before the first IVF-RT treatment cycle. K Ke ey yw wo or rd ds s: : Embryo transfer; implantation; in vitro fertilization; local endometrial injury; office hysteroscopy

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The effect of endometrial injury on first cycle IVF/ICSI outcome: A randomized controlled trial

Cited by 30 publications

References 13 publications

Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis

Endometrial scratching prior to IVF; does it help and for whom? A systematic review and meta-analysis

Endometrial scratch for infertile polycystic ovary syndrome (PCOS) women undergoing laparoscopic ovarian drilling: a randomized controlled trial

Is There any Impact of Local Endometrial Injury on Implantation and Clinical Pregnancy Rates in the First in Vitro Fertilization Cycles

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