David A Crosby1,2, Louise E Glover3,4, Paul Downey5, Eoghan E Mooney5, Fionnuala M McAuliffe6, Cliona O'Farrelly4, Donal J Brennan6, Mary Wingfield3,6,4. 1. Merrion Fertility Clinic, 60 Mount Street, Dublin 2, Ireland. crosbyd@tcd.ie. 2. UCD Obstetrics & Gynaecology, National Maternity Hospital, University College Dublin, Dublin 2, Ireland. crosbyd@tcd.ie. 3. Merrion Fertility Clinic, 60 Mount Street, Dublin 2, Ireland. 4. School of Biochemistry and Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland. 5. Department of Pathology and Laboratory Medicine, National Maternity Hospital, Dublin, Ireland. 6. UCD Obstetrics & Gynaecology, National Maternity Hospital, University College Dublin, Dublin 2, Ireland.
Abstract
INTRODUCTION: Endometrial injury or 'scratch' preceding an assisted reproductive therapy (ART) cycle has recently been shown not to improve livebirth rates among women undergoing ART. The objective of this study was to compare pregnancy outcomes in nulliparous women who underwent an accurately timed mid-luteal scratch biopsy prior to ART with those who did not. METHODS: This was a prospective cohort study. Women were recruited between October 2016 and February 2018 inclusive. Women who met the inclusion criteria and who did not undergo an endometrial scratch in the study period were used as a comparison group. Patients underwent a cycle of ART in the menstrual cycle following endometrial scratch. RESULTS: Ninety-eight women were eligible for participation in the study. There were no differences in rates of implantation (35.7% (n = 20/56) vs. 35.4% (n = 17/48); p = 1.00), clinical pregnancy (40.0% (n = 20/50) vs. 39.5% (n = 17/43); p = 1.00) or live birth (34.0% (n = 17/50) vs. 25.6% (n = 11/43); p = 0.50) per embryo transfer between those who underwent a scratch and those who did not. CONCLUSION: Endometrial scratch is a simple, inexpensive and low-risk procedure. However, in this relatively small cohort study, no differences in rates of implantation, clinical pregnancy or live birth in women with primary infertility were determined between those who underwent a scratch and those who did not.
INTRODUCTION:Endometrial injury or 'scratch' preceding an assisted reproductive therapy (ART) cycle has recently been shown not to improve livebirth rates among women undergoing ART. The objective of this study was to compare pregnancy outcomes in nulliparous women who underwent an accurately timed mid-luteal scratch biopsy prior to ART with those who did not. METHODS: This was a prospective cohort study. Women were recruited between October 2016 and February 2018 inclusive. Women who met the inclusion criteria and who did not undergo an endometrial scratch in the study period were used as a comparison group. Patients underwent a cycle of ART in the menstrual cycle following endometrial scratch. RESULTS: Ninety-eight women were eligible for participation in the study. There were no differences in rates of implantation (35.7% (n = 20/56) vs. 35.4% (n = 17/48); p = 1.00), clinical pregnancy (40.0% (n = 20/50) vs. 39.5% (n = 17/43); p = 1.00) or live birth (34.0% (n = 17/50) vs. 25.6% (n = 11/43); p = 0.50) per embryo transfer between those who underwent a scratch and those who did not. CONCLUSION: Endometrial scratch is a simple, inexpensive and low-risk procedure. However, in this relatively small cohort study, no differences in rates of implantation, clinical pregnancy or live birth in women with primary infertility were determined between those who underwent a scratch and those who did not.
Authors: Sarah Lensen; Diana Osavlyuk; Sarah Armstrong; Caroline Stadelmann; Aurélie Hennes; Emma Napier; Jack Wilkinson; Lynn Sadler; Devashana Gupta; Annika Strandell; Christina Bergh; Kugajeevan Vigneswaran; Wan T Teh; Haitham Hamoda; Lisa Webber; Sarah A Wakeman; Leigh Searle; Priya Bhide; Simon McDowell; Karen Peeraer; Yacoub Khalaf; Cynthia Farquhar Journal: N Engl J Med Date: 2019-01-24 Impact factor: 91.245
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