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Related Experiment Video

Updated: Dec 29, 2025

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Endometrial Scratch (Injury): Does Timing Matter?

Abigail Bernard1, Katelyn Schumacher1, Courtney Marsh2

  • 1School of Medicine, University of Kansas, Kansas City, Kansas, USA.

Journal of Family & Reproductive Health
|January 29, 2020
PubMed
Summary

Timing of endometrial scratch does not significantly impact implantation rates. This study found similar positive pregnancy outcomes regardless of whether the procedure occurred during the proliferative, periovulatory, or secretory phases of the menstrual cycle.

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Area of Science:

  • Reproductive Endocrinology
  • Infertility Research
  • Gynecological Procedures

Background:

  • Endometrial scratch, an intervention aimed at improving implantation rates, has shown variable results in previous studies.
  • The optimal timing of endometrial scratch within the menstrual cycle remains a subject of investigation.

Purpose of the Study:

  • To evaluate the association between the timing of endometrial scratch and subsequent pregnancy implantation.
  • To compare implantation rates following endometrial injury during different phases of the menstrual cycle.

Main Methods:

  • Retrospective chart review of women aged 18-45 undergoing endometrial scratch at a reproductive endocrine clinic.
  • Endometrial scratch timing categorized as proliferative (days 1-9), periovulatory (days 11-16), or secretory (day 19+).
Keywords:
Assisted Reproductive TechnologyEndometrial InjuryEndometrial ScratchIVF

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Last Updated: Dec 29, 2025

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  • Primary outcome: positive beta-hCG within 90 days of the procedure.

    • Main Results:

    • No statistically significant differences in baseline characteristics across the three timing groups.
    • Implantation rates (positive beta-hCG) were similar across all phases: proliferative (65.6%), periovulatory (69.6%), and secretory (64.3%).
    • The p-value for the difference in implantation rates was 0.9332, indicating no significant variation.

    Conclusions:

    • Endometrial scratch timing during the proliferative, periovulatory, or secretory phases does not significantly affect implantation rates.
    • Findings contrast with prior studies suggesting reduced implantation when performed at oocyte retrieval.
    • Performing endometrial scratch during oocyte retrieval sedation may be beneficial for patients not undergoing fresh embryo transfer, considering procedural discomfort.