Amerigo Vitagliano1, Alessandra Andrisani2, Carlo Alviggi3, Salvatore Giovanni Vitale4, Gaetano Valenti4, Fabrizio Sapia4, Alessandro Favilli5, Wellington P Martins6, Nick Raine-Ferring7, Lukasz Polanski8, Guido Ambrosini2. 1. Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy. Electronic address: amerigovitagliano.md@gmail.com. 2. Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy. 3. Department of Neuroscience, Reproductive Science, and Odontostomatology, University of Naples Federico II, Naples, Italy. 4. Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy. 5. Section of Obstetrics and Gynecology, Department of Surgical and Biomedical Sciences, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy. 6. SEMEAR Fertilidade, São Paolo, Brazil. 7. Division of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom. 8. Division of Obstetrics and Gynaecology, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, United Kingdom; NURTURE Fertility, Nottingham, United Kingdom.
Abstract
OBJECTIVE: To investigate endometrial scratch injury (ESI) as an intervention to improve IVF outcome in women undergoing a first ET. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Infertile women undergoing a first fresh/frozen embryo transfer. INTERVENTION(S): We included published and unpublished data from randomized controlled trials in which the intervention group received ESI and controls received placebo or no intervention. Pooled results were expressed as relative risk (RR) with 95% confidence interval (CI). The review protocol was registered in PROSPERO to start the data extraction (CRD42018087786). MAIN OUTCOME MEASURE(S): Ongoing pregnancy/live birth rate (OPR/LBR), clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), miscarriage rate (MR), and ectopic pregnancy rate (EPR). RESULT(S): Seven studies were included (1,354 participants). We found a nonsignificant difference between groups in terms of OPR/LBR, CPR, MR, MPR, and EPR. Subgroup analysis found that ESI on the day of oocyte retrieval (achieved by a Novak curette) reduced OPR/LBR (RR 0.31, 95% CI 0.14-0.69) and CPR (RR 0.36, 95% CI 0.18-0.71), whereas ESI during the cycle preceding ET (performed through soft devices) had no effect on OPR/LBR and CPR. No difference in the impact of ESI was observed between fresh and frozen embryo transfer. CONCLUSION(S): Current evidence does not support performing ESI with the purpose of improving the success of a first ET attempt.
OBJECTIVE: To investigate endometrial scratch injury (ESI) as an intervention to improve IVF outcome in women undergoing a first ET. DESIGN: Systematic review and meta-analysis. SETTING: Not applicable. PATIENT(S): Infertilewomen undergoing a first fresh/frozen embryo transfer. INTERVENTION(S): We included published and unpublished data from randomized controlled trials in which the intervention group received ESI and controls received placebo or no intervention. Pooled results were expressed as relative risk (RR) with 95% confidence interval (CI). The review protocol was registered in PROSPERO to start the data extraction (CRD42018087786). MAIN OUTCOME MEASURE(S): Ongoing pregnancy/live birth rate (OPR/LBR), clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), miscarriage rate (MR), and ectopic pregnancy rate (EPR). RESULT(S): Seven studies were included (1,354 participants). We found a nonsignificant difference between groups in terms of OPR/LBR, CPR, MR, MPR, and EPR. Subgroup analysis found that ESI on the day of oocyte retrieval (achieved by a Novak curette) reduced OPR/LBR (RR 0.31, 95% CI 0.14-0.69) and CPR (RR 0.36, 95% CI 0.18-0.71), whereas ESI during the cycle preceding ET (performed through soft devices) had no effect on OPR/LBR and CPR. No difference in the impact of ESI was observed between fresh and frozen embryo transfer. CONCLUSION(S): Current evidence does not support performing ESI with the purpose of improving the success of a first ET attempt.
Authors: David A Crosby; Louise E Glover; Paul Downey; Eoghan E Mooney; Fionnuala M McAuliffe; Cliona O'Farrelly; Donal J Brennan; Mary Wingfield Journal: Ir J Med Sci Date: 2020-10-22 Impact factor: 1.568
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: 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