Endometrial ‘scratching’: what the data show

Santamaría, Xavier Alegre; Katzorke, Nora; Simón, Carlos

doi:10.1097/gco.0000000000000279

Cited by 31 publications

(18 citation statements)

References 21 publications

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“…Several reviews on endometrial scratching have been published (El-Toukhy et al , 2012; Potdar et al , 2012; Nastri et al , 2015; Panagiotopoulou et al , 2015; Ko and Ng, 2016; Santamaria et al , 2016; Zygula et al , 2016), of which four did not and three did perform a meta-analysis (El-Toukhy et al , 2012; Potdar et al , 2012; Nastri et al , 2015). All reviews used different inclusion criteria (scratching prior to or during ovarian stimulation, number of previously failed IVF/ICSI cycles, only RCTs versus also non-randomized trials), so that none of the reviews included the same publications.…”

Section: Discussionmentioning

confidence: 99%

“…The reviews by Santamaria et al . 2016, Zygula et al 2016 and Ko and Ng, 2016 have a more narrative style, and do not report a clear search or inclusion/exclusion criteria for the RCTs. Santamaria et al 2016 reviewed 16 RCTs with a total of 2570 participants who were either trying to conceive naturally, by IUI or through IVF/ICSI treatment, and specifically focused on the studies published in 2014/2015 in order to explain the different conclusions between the reviews of Nastri et al .…”

Section: Discussionmentioning

confidence: 99%

“…Comparable to the wide spectrum of results of the randomized controlled trials (RCTs), the reviews also differ in their interpretation of the results. While some reviews concluded that endometrial scratching is associated with increased clinical pregnancy rate (CPR) and/or live birth rate (LBR) (El-Toukhy et al , 2012; Potdar et al , 2012; Nastri et al , 2015; Ko and Ng, 2016), others stated that no conclusion could yet be drawn (Panagiotopoulou et al , 2015; Santamaria et al , 2016; Zygula et al , 2016). Importantly, all reviews stress that (part of) their conclusions are based on moderate-quality studies that were compromised by high clinical heterogeneity, and/or that endometrial scratching should not be implemented in daily practice for all patients since it remains unclear if it is beneficial for all patients or only for certain subgroups.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

show abstract

“…Early follicular endometrial scratching during the menstruation can remove endometrial local lesions, such as polyps, dysplasia and abnormal thickening . Shallow endometrial scratching not only removed abnormal endometrium, but also increased the secretion of certain cytokines or growth factors such as interleukin 1, heparin‐binding epidermal growth factor‐like growth factor and proinflammatory factors which play important role in embryo implantation . In this study, the clinical pregnancy rate of Group D (EMT > 7 mm) was significantly lower compared to other groups.…”

Section: Discussionmentioning

confidence: 56%

Impact of endometrial thickness during menstruation and endometrial scratching on the pregnancy in frozen–thawed embryo transfer

Liu

Nong

Ruan

et al. 2018

J of Obstet and Gynaecol

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Aim: This study aimed to investigate the impact of endometrial thickness (EMT) during menstruation and endometrial scratching on the pregnancy in frozen-thawed embryo transfer (FET). Methods: About 1298 patients receiving FET were retrospectively analyzed and divided according to EMT on the 4th or 5th day of menstruation. Group A: EMT ≤ 3.0 mm; Group B: EMT 3.1-5.0 mm; Group C: EMT 5.1-7.0 mm and Group D: EMT > 7.0 mm. Patients in Group D were further divided to scratching group and nonscratching group. Endometrial growth was defined as the change in EMT from 4th or 5th day of menstruation to the day of embryo transferred. Results: We found no significant differences in general conditions among four groups (P > 0.05). The average EMT during menstruation and differences in inter-group endometrial growth of four groups had statistical significance (P < 0.05). The pregnancy rate and implantation rate of Group D were significantly lower than other groups (P < 0.001). Pregnancy rate (68.29% vs 53.26%) and implantation rate (52.67% vs 36.34%) in endometrial scratching group were higher than those in nonscratching group (P < 0.05). Conclusion: Higher EMT during menstruation adversely affects pregnancy outcomes following FET. Endometrial scratching may improve the receptivity of endometrium and increase the rate of embryo implantation and pregnancy.

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“…Is There any Impact of Local Endometrial Injury on Implantation and Clinical Pregnancy Rates in the First in Vitro Fertilization Cycles pregnancy rates in patients at the first IVF-ET cycle was presented by Karimzade et al However, the therapeutic impact of LEI still remains unclear due to the heterogeneity of the patient population, timing of this intervention and techniques for inducing endometrial injury. [6][7][8] The purpose of the present study was to demonstrate the effect of LEI, applied before the first IVF-ET cycle, using office hysteroscopy, on implantation and pregnancy rates.…”

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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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Endometrial ‘scratching’: what the data show

Cited by 31 publications

References 21 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

Impact of endometrial thickness during menstruation and endometrial scratching on the pregnancy in frozen–thawed embryo transfer

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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