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Posted by on Jan 31, 2020 in Infertility | 0 comments

In a nutshell

This study investigated if endometrial (uterus lining) scratching (ES) before in vitro fertilization (IVF) improves fertility outcomes in women with recurrent implantation failure. 

They found that ES improved fertility outcomes in these patients

Some background

Live birth rates (LBR) with in vitro fertilization (IVF) have increased in recent times. However, IVF failure is still relatively common. Recurrent implantation failure (RIF) is another term for this. The cause of RIF is often unclear. Multiple factors may affect RIF. Embryo quality and endometrium receptivity (EMR) are examples. The endometrium is the lining of the uterus. 

EMR is very important for IVF success. Patients with RIF are treated with hormones to stimulate EMR. Endometrial scratching (ES) is another method of preparing the endometrium. ES involves using a catheter (thin tube) to make two scratches in the endometrium. This may improve the implantation of the embryo after IVF. The exact mechanism behind ES is unknown. It is unclear if ES improves fertility outcomes in women with RIF. 

Methods & findings

This study included 300 IVF cycles in women with RIF. Patients were allowed to decide if they wanted to undergo ES. 77 cyles involved ES. Embryos were transferred after ES. Fertility outcomes measured included LBR, implantation rates (IR) and clinical pregnancy rate (CPR). 

IR was significantly higher after ES (19.7%) compared to women who did not have ES (0.4%). CPR was also significantly higher with ES (38.4%) than in non-ES patients (0.9%). LBR was 33.33% in the ES group and 0.45% in non-ES patients. More high-quality embryos were transferred after ES. This could have had an effect on the fertility outcomes in this study. 

The bottom line

The authors concluded that ES improved fertility outcomes in patients with RIF.

The fine print

This study was based on data from medical records. Some factors may not be accounted for. More controlled studies are needed. 

What’s next?

If you have any concerns regarding infertility management please discuss this with your doctor. 

Published By :

Archives of Gynecology and Obstetrics

Date :

Jan 02, 2020

Original Title :

Recurrent implantation failure: which patients benefit from endometrial scratching prior to IVF?

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