Decrease in pregnancy rate after endometrial scratch in women undergoing a first or second in vitro fertilization. A...

Area of Science:

• Reproductive Medicine
• In Vitro Fertilization (IVF)
• Assisted Reproductive Technologies (ART)

Background:

• Previous research suggested endometrial scratching could enhance embryo implantation rates.
• The precise mechanism and efficacy of endometrial scratching remain areas of investigation in IVF protocols.

Purpose of the Study:

• To determine if endometrial scratch (ES) improves clinical pregnancy rates (CPR) in women undergoing their first or second IVF/ICSI attempt.
• To evaluate the impact of a specific endometrial scratching technique on IVF outcomes.

Main Methods:

• A randomized controlled multi-center trial comparing endometrial scratch (ES) versus no ES.
• Patients were randomized, and ES was performed in the luteal phase preceding ovarian stimulation.
• Clinical pregnancy rate (CPR) was the primary outcome, analyzed on an intent-to-treat basis.

Main Results:

• The clinical pregnancy rate (CPR) was lower in the ES arm (23.5%) compared to the non-ES arm (35.9%), though not statistically significant (P=0.0568).
• Implantation rates were 19.1% for ES and 24.0% for non-ES.
• The study was stopped prematurely due to a trend towards lower pregnancy rates in the ES group, failing to reach the planned sample size.

Conclusions:

• Endometrial scratching, as performed in this study, did not enhance clinical pregnancy rates for women in their first or second IVF/ICSI cycle.
• The findings suggest that the specific technique and timing of endometrial scratching used may not be beneficial for improving IVF success rates.