Targeted Endometrial Scratching: An Example of Endometrial Diagnosis Usage in Reproductive Medicine

Rahmati, Mona; Lédée, Nathalie

doi:10.3389/fimmu.2020.589677

Cited by 6 publications

(7 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The results of our study revealed notable alterations in the expression levels of and proliferation are all involved in the healing process that follows scratching, during which angiogenesis occurs during the proliferation phase (12,24).…”

Section: Discussionmentioning

confidence: 67%

“…Additionally, ES may stimulate angiogenesis, promoting the formation of new blood vessels in the endometrium and thereby establishing a more supportive environment for successful embryo implantation. Furthermore, the procedure is thought to modulate the local immune response, influencing immune cell activity and cytokine release to create a microenvironment conducive to embryo implantation (12).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Endometrial scratching in unexplained repeated implantation failure causes two competing forces, angiogenesis and anti-angiogenesis: An RCT study

Aghajanpour,

Mehraein,

Amjadi

et al. 2024

IJRM

View full text Add to dashboard Cite

Background: A significant association between endometrial vascularity and pregnancy has been shown in previous research, while poor vascularization was attributed to repeated implantation failure (RIF). One possible approach to enhance angiogenesis for successful implantation is endometrial scratching (ES). Objective: The purpose was to investigate endometrial responses to scratching by profiling angiogenesis-related gene expression in unexplained RIF participants. Materials and Methods: In this randomized controlled trial study, 20 infertile women with unexplained RIF were assigned to 2 groups by the balanced block randomization method (n = 10/each group): the intervention group (group A) (who received ES in the follicular phase) and the control group (group B). Endometrial biopsy was performed in the secretory phase. Gene expression profiling was performed using a polymerase chain reaction-array kit for humanangiogenic growth factors. The implantation and clinical pregnancy rates were also assessed. Results: Among the angiogenesis-promoting genes, FGF1, FGF13, FGF2, TGFA, ANG, ANGPT1, and VEGFA were significantly upregulated (p < 0.05). IL12A (an angiogenesis-inhibiting cytokine) was significantly upregulated (p < 0.01). In contrast, 15 genes with angiogenesisrelated functions, including CXCL11, CXCL13, CXCL3, CXCL5, CXCL6, EREG, FIGF, FST, IL10, LEP, PPBP, PROK1, RHOB, TNF, and TYMP, were downregulated after ES. No significant differences were observed between the intervention (group A) and control (group B) groups in terms of implantation (43.75% vs. 28.57%) or clinical pregnancy rates (75% vs. 57.1%). Conclusion: ES induced significant alterations in the expression of angiogenesis-related genes, with notable up/downregulation of key angiogenic/antiangiogenic factors. These findings enhance our understanding of the molecular responses triggered by ES, underscoring the potential influence of ES on the complex processes of angiogenesis crucial for implantation. Key words: Endometrium, Angiogenesis, Embryo implantation, Polymerase chain reaction.

show abstract

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Endometrial scratching in unexplained repeated implantation failure causes two competing forces, angiogenesis and anti-angiogenesis: An RCT study

Aghajanpour,

Mehraein,

Amjadi

et al. 2024

IJRM

View full text Add to dashboard Cite

show abstract

“…Research indicates that scratching seems to be a measure of success in upgrading the pregnancy rate of women with failed implantation. [46][47][48] We aim to highlight some of the research directions proposed for achieving of a one-time pregnancy in ART to investigate the clinical utility of targeted endometrial scratching. There is insufficient evidence to support the use of endometrial scratching in the treatment of ART and no consensus has been established regarding the efficacy, safety, and optimal timing of this intervention.…”

Section: Discussionmentioning

confidence: 99%

Impact of endometrial scratching on reproductive outcome in patients: A systematic review and meta-analysis

et al. 2022

View full text Add to dashboard Cite

Background: Endometrial scratching (ES) has demonstrated initial success in women with recurrent implantation failure, but the effect in women with 1 previous assisted reproductive technology (ART) failure is unknown. This meta-analysis aimed to evaluate the impact of ES as a treatment in clinical outcomes for women with at least 1 failed in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI)/Intrauterine Insemination (IUI).Methods: PubMed, Medline, Embase, Cochrane Library, Web of Science, CNKI, and EMCC databases were searched for randomized controlled trial studies utilizing endometrial scratching for infertility women with at least 1 failed assisted reproductive technology (ART) to collect pregnancy outcomes, including clinical pregnancy rate (CPR), embryo implantation rate (IR), miscarriage rate (MR), live birth rate (LBR), and multiple pregnancy rate (MPR).Results: Sixteen randomized controlled trial (RCT) studies were included in this meta-analysis, including 1770 women in the intervention group and 1934 women in the control group. Overall, the CPR, IR and LBR were significantly higher in the intervention group than in the control group (for CPR, n = 1430, 16 studies, P = .0002, risk ratio (RR) = 1.59, 95% confidence interval [CI] [1.24, 2.03]; for IR, n = 859, 10 studies, P = .0003, RR = 1.67, 95% CI [1.26, 2.21]; for LBR, n = 156, 6 studies, P = .0005, RR = 1.59, 95% CI [1.22, 2.06]). Nonetheless, there was no significant difference in MR (n = 344, 11 studies, P = .62, risk ratio (RR) = 0.92, 95% confidence interval [CI] [0.66, 1.29]) and MPR (n = 98, 3 studies, P = .39, risk ratio (RR) = 0.81, 95% confidence interval [CI] [0.51, 1.30]) between the intervention group and the control group. Conclusion:Endometrial scratching is considered to enhance the reproductive outcomes of embryo implantation. Additional randomized controlled studies are recommended to identify the appropriate time of invasion and the applicable population to confirm whether it can become a routine operation. Abbreviations: 95%CI = 95% confidence interval, ART = assisted reproductive technology, CPR = clinical pregnancy rate, ES = endometrial scratching, ICSI = intracytoplasmic sperm injection, IR = embryo implantation rate, IUI = intrauterine insemination, IVF = in vitro fertilization, LBR = live birth rate, MPR = multiple pregnancy rate, MR = miscarriage rate, PCOS = polycystic ovary syndrome, PRISMA = Preferred Reporting Items for Reviews and Meta-Analyses, PROSPERO = International Prospective Register of Systematic Reviews, RCT = randomized controlled trial, RIF = recurrent implantation failure, RR = risk ratio, WMDs = weighted mean differences.

show abstract

“…Last, in a metaanalysis subgroup analysis performed by Vitagliano et al (7 studies,702 patients), while patients with ≥2 previously failed ET had a higher LBR with EST (RR: 1.64, 95% CI: 1.21-2.21, P = 0.001), this was likely driven by cofounding factors such as hysteroscopy, antibiotics or prednisolone administered to the patients randomized to EST (Vitagliano et al 2018). As such, EST is not currently recommended in Canada for RIF (Shaulov et al 2020); however, as with other immunomodulatory therapies, the intervention may be most useful in select patients whose characteristics are still being identified (Ledee et al 2020b, Rahmati & Ledee 2020.…”

Section: Endometrial Scratchmentioning

confidence: 99%

Immunomodulation for unexplained recurrent implantation failure: where are we now?

et al. 2023

View full text Add to dashboard Cite

Recurrent implantation failure (RIF) may be defined as the absence of pregnancy despite the transfer of ≥ 3 good quality blastocysts and is unexplained in up to 50% of cases. There are currently no effective treatments for patients with unexplained RIF. Since the maternal immune system is intricately involved in mediating endometrial receptivity and embryo implantation, both insufficient and excessive endometrial inflammatory responses during the window of implantation are proposed to lead to implantation failure. Recent strategies to improve conception rates in RIF patients have focused on modulating maternal immune responses at implantation, either through promoting or suppressing inflammation. Unfortunately, there are no validated, readily available diagnostic tests to confirm immune-mediated RIF. As such, immune therapies are often started empirically without robust evidence as to their efficacy. Like other chronic diseases, patient selection for immunomodulatory therapy is crucial and personalized medicine for RIF patients is emerging. As the literature on the subject is heterogenous and rapidly evolving, we aim to summarize the potential efficacy, mechanisms of actions and side effects of select therapies for the practicing clinician.

show abstract

Targeted Endometrial Scratching: An Example of Endometrial Diagnosis Usage in Reproductive Medicine

Cited by 6 publications

References 35 publications

Endometrial scratching in unexplained repeated implantation failure causes two competing forces, angiogenesis and anti-angiogenesis: An RCT study

Endometrial scratching in unexplained repeated implantation failure causes two competing forces, angiogenesis and anti-angiogenesis: An RCT study

Impact of endometrial scratching on reproductive outcome in patients: A systematic review and meta-analysis

Immunomodulation for unexplained recurrent implantation failure: where are we now?

Contact Info

Product

Resources

About