Does endometrial scratching really improve intrauterine insemination outcome? Injury timing can make a huge difference

Vitagliano, Amerigo; Saccardi, Carlo; Noventa, Marco; Sardo, Attilio Di Spiezio; Laganà, Antonio Simone; Litta, P.

doi:10.1016/j.jogoh.2017.11.001

Cited by 17 publications

(15 citation statements)

References 9 publications

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“…This could be due to a combination of the corrected uterine pathology, and a potentially beneficial effect induced by the endometrial trauma of HSC-P, similar to those of endometrial scratching [41][42][43][44]. However, the extent of this beneficial effect is uncertain, as some researchers have suggested that the benefits of endometrial scratching are lost after one menstrual cycle [45,46]. In addition, a prospective controlled trial demonstrated that when endometrial scratching was performed at the time of OPU or concurrent to the embryo transfer cycle, decreased pregnancy rates have resulted [47,48].…”

Section: Plos Onementioning

confidence: 99%

Optimal time interval between hysteroscopic polypectomy and frozen-thawed blastocyst transfer: A retrospective study

Yang

Chen

et al. 2020

PLoS ONE

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The optimal timing of frozen-thawed blastocyst transfer following hysteroscopic polypectomy is an important and unanswered clinical question. In this study, we conducted a retrospective survey of cases from an infertility center at an academic hospital. We reviewed the charts of all patients who received in-vitro fertilization and frozen-thawed blastocyst transfers (FBT) at the center from January 2009 to November 2019. One hundred and two patients with prior diagnosis of endometrial polyp that were treated with hysteroscopic polypectomy before received their first FBT at the center were identified as cases. Patients without prior diagnosis of endometrial polyp, and who received their first FBT at the center were defined as controls. Controls were enrolled at a 1-to-1 ratio to the cases. The cases and controls did not show differences in baseline characteristics, endometrial thickness, or the number of good blastocysts transferred. The clinical pregnancy rates and live birth rates were similar. Regarding the optimal interval between polypectomy and FBT, a cutoff of 120 days was identified from the ROC curve. A stratified analysis showed that when FBT was performed within an interval of 120 days after polypectomy, there were higher biochemical pregnancy rates (73.2%, 45.2%; OR 3.3; P = .007) and clinical pregnancy rates (64.8%, 41.9%; OR 2.54; P = .032), when compared with intervals greater than 120 days. There were no significant differences in implantation and live birth rates. In conclusion, pregnancy rates following FBT in patients who had received prior endometrial polypectomy were comparable to pregnancy rates after FBT in patients without endometrial polyp. Subgroup analysis showed that an interval greater than 120 days between hysteroscopic polypectomy and FBT was associated with decreased pregnancy rates. Patients who wish to receive embryo transfer after polypectomy should wait no longer than 120 days.

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Section: Plos Onementioning

confidence: 99%

Optimal time interval between hysteroscopic polypectomy and frozen-thawed blastocyst transfer: A retrospective study

Yang

Chen

et al. 2020

PLoS ONE

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“…Most recently hypothesized is the "backward development hypothesis" which states that endometrial scratch injury may delay endometrial maturation, minimizing the negative effects of ovarian stimulation and implantation [50][51][52]. Another hypothesis is that injury may trigger the massive secretion of growth factors and cytokines which may be beneficial for embryo implantation [53,54]. The last hypothesis is based on animal models, in which injury may induce rapid growth of the endometrial cells in a similar fashion to that of the decidual cells in humans [50,51,[53][54][55][56].…”

Section: Impact Of Endometrial Stimulationmentioning

confidence: 99%

“…Another hypothesis is that injury may trigger the massive secretion of growth factors and cytokines which may be beneficial for embryo implantation [53,54]. The last hypothesis is based on animal models, in which injury may induce rapid growth of the endometrial cells in a similar fashion to that of the decidual cells in humans [50,51,[53][54][55][56].…”

Section: Impact Of Endometrial Stimulationmentioning

confidence: 99%

The Effect of Hysteroscopy on the Reproductive Outcomes of Infertile Women Without Intrauterine Pathologies: A Systematic Review and Meta-Analysis

Yang¹,

Lee²,

Chon³

2020

Preprint

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(1) Background: The aim of this work was to systematically review existing studies on whether hysteroscopy improves the reproductive outcomes of women with infertility even in the absence of intrauterine pathologies when compared to women who did not receive a hysteroscopy. (2) Methods: We established the Participant-Intervention-Comparison-Outcome strategy and used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement to conduct a systematic review of 11 studies which were retrieved from 3 electronic databases: Ovid-Medline, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data from the included studies and used the Cochrane risk-of-bias tool to assess their quality. (3) Results: The primary outcome measures were the clinical pregnancy rates (CPRs) and live birth rates (LBRs) in the in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Hysteroscopy in infertile women without intrauterine pathologies showed higher CPRs and LBRs than those in the same population who did not receive hysteroscopy in cases of recurrent implantation failure and IVF (odds ratio: 1.79 and 1.46, 95% confidence interval: 1.46-2.30 and 1.08-1.97 for CPR and LBR, respectively); however, the degree of significance was not as high for LBR. (4) Conclusions: Hysteroscopy before IVF/ICSI in infertile women without intrauterine pathologies may potentially be effective in improving the CPRs and LBRs in patients with RIF. Robust and high-quality randomized trials are warranted to confirm this finding.

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“…Different strategies have been proposed to improve the outcome of IUI‐stimulated cycles, including endometrial scratching, various ovarian stimulation protocols and pituitary block with gonadotrophin‐releasing hormone (GnRH) antagonists (GnRH‐ant) …”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3] The rationale is to increase the natural chances of conceiving by obtaining two or three dominant follicles and performing IUI after multiple ovulation triggering. 4 Different strategies have been proposed to improve the outcome of IUI-stimulated cycles, including endometrial scratching, 5 various ovarian stimulation protocols 6,7 and pituitary block with gonadotrophin-releasing hormone (GnRH) antagonists (GnRH-ant). 4 These antagonists are synthetic analogues of GnRH that exert a competitive block of GnRH receptors in the anterior pituitary gland.…”

Section: Introductionmentioning

confidence: 99%

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

Vitagliano

Saccone

Noventa

et al. 2018

BJOG

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Does endometrial scratching really improve intrauterine insemination outcome? Injury timing can make a huge difference

Cited by 17 publications

References 9 publications

Optimal time interval between hysteroscopic polypectomy and frozen-thawed blastocyst transfer: A retrospective study

Optimal time interval between hysteroscopic polypectomy and frozen-thawed blastocyst transfer: A retrospective study

The Effect of Hysteroscopy on the Reproductive Outcomes of Infertile Women Without Intrauterine Pathologies: A Systematic Review and Meta-Analysis

Pituitary block with gonadotrophin‐releasing hormone antagonist during intrauterine insemination cycles: a systematic review and meta‐analysis of randomised controlled trials

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