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Endometrial 'scratching': what the data show.

Xavier Santamaria1, Nora Katzorke, Carlos Simón

  • 1aDepartment of Obstetrics and Gynecology, Universidad de Valencia, Instituto Universitario IVI, INCLIVA, Valencia, Spain bDepartment of Obstetrics and Gynecology, Heinrich Heine University Medical Center, Duesseldorf, Germany cDepartment of Obstetrics and Gynecology, Stanford University, Stanford, California, USA.

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|June 4, 2016
PubMed
Summary
This summary is machine-generated.

Endometrial scratching, a procedure to enhance fertility, lacks evidence of effectiveness. Recent studies show no improvement in live birth rates, suggesting it may be ineffective and potentially harmful.

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Area of Science:

  • Reproductive Medicine
  • Gynecology
  • Clinical Trials

Background:

  • Endometrial scratching is a widely discussed procedure aimed at improving endometrial receptivity for assisted reproduction.
  • Despite its accessibility and adoption into clinical practice, the scientific basis and efficacy remain controversial.
  • Over 1000 studies have investigated this intervention since 2003.

Purpose of the Study:

  • To critically review the existing data on the efficiency of endometrial scratching, with a focus on studies published in the last two years.
  • To evaluate the clinical effectiveness of endometrial scratching in improving reproductive outcomes.

Main Methods:

  • Systematic review and critical analysis of recent randomized controlled studies and meta-analyses.
  • Focus on data from 2014 and 2015, examining heterogeneity in study design, patient populations, and intervention protocols.
  • Evaluation of reported reproductive outcomes, particularly live birth rates.

Main Results:

  • Five randomized controlled studies, one meta-analysis, and one systematic review published between 2014-2015 were analyzed.
  • Significant heterogeneity was observed across studies regarding methodology and intervention details.
  • None of the reviewed studies demonstrated a significant improvement in live birth rates following endometrial scratching.

Conclusions:

  • Current evidence from well-designed randomized controlled trials indicates no beneficial effect of endometrial scratching.
  • The biological mechanisms underlying the purported effects of endometrial scratching are not established.
  • The procedure incurs costs, causes pain, and carries potential risks such as Asherman syndrome, questioning its routine clinical use.