Mia Steengaard Olesen1, Benedicte Hauge2, Lisbeth Ohrt2, Tine Nørregaard Olesen3, Janne Roskær3, Vibeke Bæk3, Helle Olesen Elbæk4, Bugge Nøhr5, Mette Nyegaard6, Michael Toft Overgaard7, Peter Humaidan4, Axel Forman8, Inge Agerholm2. 1. Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark. Electronic address: miasolesen@gmail.com. 2. Fertility Clinic, Horsens Regional Hospital, Horsens, Denmark. 3. Fertility Clinic, Aalborg University Hospital, Aalborg, Denmark. 4. Fertility Clinic, Skive Regional Hospital, Skive. 5. Fertility Clinic, Department of Obstetrics and Gynecology, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark. 6. Department of Biomedicine, Aarhus University, Aarhus, Denmark. 7. Department of Chemistry and Bioscience, Aalborg University, Aalborg, Denmark. 8. Department of Gynecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark.
Abstract
OBJECTIVE: To study whether endometrial scratching in the luteal phase before ovarian stimulation increases clinical pregnancy rates in women with one or more previous implantation failures. DESIGN: A nonblinded multicenter randomized clinical trial. SETTING: Fertility clinics. PATIENT(S): Three hundred four eligible patients scheduled for IVF/intracytoplasmic sperm injection were randomized. The intervention group (n = 151) underwent endometrial scratching in the luteal phase before controlled ovarian stimulation, while no intervention was performed in the control group (n = 153). INTERVENTION(S): Endometrial scratching with a Pipelle de Cornier catheter in the luteal phase before ovarian stimulation. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate and prenatal and birth data. RESULT(S): There was no overall significant improvement in clinical pregnancy rates between the control and intervention groups (38.5% vs. 44.4%; relative risk = 1.15; confidence interval [0.86-1.55]). However, subgroup analyses revealed that women with three or more previous implantation failures had a significant increase in clinical pregnancy rate (31.1% vs. 53.6%; relative risk = 1.72; confidence interval [1.05-2.83]) after scratching. No difference was seen as regards prenatal and birth data between the two groups. CONCLUSION(S): Endometrial scratching in the luteal phase before ovarian stimulation significantly enhances the clinical pregnancy rate in women with three or more prior implantation failures. This result seems to corroborate previous reports, which found that particularly women with repeated implantation failure seem to gain a positive effect from endometrial scratching. Importantly, there were no significant differences in prenatal data and birth data between the groups. CLINICAL TRIAL REGISTRATION NUMBER: NCT01963819.
RCT Entities:
OBJECTIVE: To study whether endometrial scratching in the luteal phase before ovarian stimulation increases clinical pregnancy rates in women with one or more previous implantation failures. DESIGN: A nonblinded multicenter randomized clinical trial. SETTING: Fertility clinics. PATIENT(S): Three hundred four eligible patients scheduled for IVF/intracytoplasmic sperm injection were randomized. The intervention group (n = 151) underwent endometrial scratching in the luteal phase before controlled ovarian stimulation, while no intervention was performed in the control group (n = 153). INTERVENTION(S): Endometrial scratching with a Pipelle de Cornier catheter in the luteal phase before ovarian stimulation. MAIN OUTCOME MEASURE(S): Clinical pregnancy rate and prenatal and birth data. RESULT(S): There was no overall significant improvement in clinical pregnancy rates between the control and intervention groups (38.5% vs. 44.4%; relative risk = 1.15; confidence interval [0.86-1.55]). However, subgroup analyses revealed that women with three or more previous implantation failures had a significant increase in clinical pregnancy rate (31.1% vs. 53.6%; relative risk = 1.72; confidence interval [1.05-2.83]) after scratching. No difference was seen as regards prenatal and birth data between the two groups. CONCLUSION(S): Endometrial scratching in the luteal phase before ovarian stimulation significantly enhances the clinical pregnancy rate in women with three or more prior implantation failures. This result seems to corroborate previous reports, which found that particularly women with repeated implantation failure seem to gain a positive effect from endometrial scratching. Importantly, there were no significant differences in prenatal data and birth data between the groups. CLINICAL TRIAL REGISTRATION NUMBER: NCT01963819.
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