Amerigo Vitagliano1, Attilio Di Spiezio Sardo2, Gabriele Saccone3, Gaetano Valenti4, Fabrizio Sapia4, Mohan S Kamath5, Mija Blaganje6, Alessandra Andrisani7, Guido Ambrosini7. 1. Department of Women and Children's Health, Unit of Gynecology and Obstetrics, University of Padua, Padua, Italy. Electronic address: amerigovitagliano.md@gmail.com. 2. Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy. 3. Department of Neuroscience Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy. 4. Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy. 5. Reproductive Medicine Unit, Christian Medical College Hospital, Vellore, India. 6. Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia. 7. Department of Women and Children's Health, Unit of Gynecology and Obstetrics, University of Padua, Padua, Italy.
Abstract
OBJECTIVE: To investigate endometrial scratch injury (ESI) as an intervention to improve IVF outcome in women with a history of ET failure. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Infertile women undergoing IVF after one or more failed ET. INTERVENTION(S): We included all randomized controlled trials of women undergoing IVF after one or more failed ET, where the intervention group received ESI and controls received placebo or no intervention. Pooled results were expressed as relative risk (RR) with a 95% confidence interval (95% CI). The review protocol was registered in PROSPERO before starting the data extraction (CRD42017082777). MAIN OUTCOME MEASURE(S): Live birth rate (LBR), clinical pregnancy rate (PR), multiple PR, miscarriage rate, ectopic pregnancy (EP) PR. RESULT(S): Ten studies were included (1,468 participants). The intervention group showed higher LBR (RR 1.38, 95% CI 1.05-1.80) and clinical PR (RR 1.34, 95% CI 1.07-1.67) in comparison to controls, without difference in terms of multiple PR, miscarriage rate, and EP PR. Double luteal ESI with pipelle was associated with the greatest effect on LBR (RR 1.54, 95% CI 1.10-2.16) and clinical PR (RR 1.30, 95% CI 1.03-1.65). The ESI was beneficial for patients with two or more previous ET failure, but not for women with a single previous failed ET. No effect was found in women undergoing frozen-thawed ET cycles. CONCLUSION(S): The ESI may improve IVF success in patients with two or more previous ET failures undergoing fresh ET. The ESI timing and technique seem to play a crucial role in determining its effect on embryo implantation.
OBJECTIVE: To investigate endometrial scratch injury (ESI) as an intervention to improve IVF outcome in women with a history of ET failure. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Infertile women undergoing IVF after one or more failed ET. INTERVENTION(S): We included all randomized controlled trials of women undergoing IVF after one or more failed ET, where the intervention group received ESI and controls received placebo or no intervention. Pooled results were expressed as relative risk (RR) with a 95% confidence interval (95% CI). The review protocol was registered in PROSPERO before starting the data extraction (CRD42017082777). MAIN OUTCOME MEASURE(S): Live birth rate (LBR), clinical pregnancy rate (PR), multiple PR, miscarriage rate, ectopic pregnancy (EP) PR. RESULT(S): Ten studies were included (1,468 participants). The intervention group showed higher LBR (RR 1.38, 95% CI 1.05-1.80) and clinical PR (RR 1.34, 95% CI 1.07-1.67) in comparison to controls, without difference in terms of multiple PR, miscarriage rate, and EP PR. Double luteal ESI with pipelle was associated with the greatest effect on LBR (RR 1.54, 95% CI 1.10-2.16) and clinical PR (RR 1.30, 95% CI 1.03-1.65). The ESI was beneficial for patients with two or more previous ET failure, but not for women with a single previous failed ET. No effect was found in women undergoing frozen-thawed ET cycles. CONCLUSION(S): The ESI may improve IVF success in patients with two or more previous ET failures undergoing fresh ET. The ESI timing and technique seem to play a crucial role in determining its effect on embryo implantation.
Authors: Bich Ngoc Bui; Sarah F Lensen; Ahmed Gibreel; Wellington P Martins; Helen Torrance; Frank J Broekmans Journal: Cochrane Database Syst Rev Date: 2021-03-18
Authors: N E van Hoogenhuijze; F Mol; J S E Laven; E R Groenewoud; M A F Traas; C A H Janssen; G Teklenburg; J P de Bruin; R H F van Oppenraaij; J W M Maas; E Moll; K Fleischer; M H A van Hooff; C H de Koning; A E P Cantineau; C B Lambalk; M Verberg; A M van Heusden; A P Manger; M M E van Rumste; L F van der Voet; Q D Pieterse; J Visser; E A Brinkhuis; J E den Hartog; M W Glas; N F Klijn; S van der Meer; M L Bandell; J C Boxmeer; J van Disseldorp; J Smeenk; M van Wely; M J C Eijkemans; H L Torrance; F J M Broekmans Journal: Hum Reprod Date: 2021-01-01 Impact factor: 6.918
Authors: Sarah F Lensen; Sarah Armstrong; Ahmed Gibreel; Carolina O Nastri; Nick Raine-Fenning; Wellington P Martins Journal: Cochrane Database Syst Rev Date: 2021-06-10