Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- 5A DHEA Is an Effective Treatment for Poor Responders
- 5B DHEA Is an Effective Treatment for Poor Responders
- 6A The Addition of LH/hCG to FSH Improves IVF Outcome
- 6B The Addition of LH/hCG to FSH Improves IVF Outcome
- 7A Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 7B Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 8A There Is a Role for Pre-conceptional Treatment with CoQ10
- 8B There Is a Role for Pre-conceptional Treatment with CoQ10
- 9A There Is a Role for Pre-conceptional Treatment with Vitamin D
- 9B There Is a Role for Pre-conception Treatment with Vitamin D
- 10A Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 10B Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 11A Intralipid Therapy Has a Place in Infertility Treatment
- 11B Intralipid Therapy Has a Place in Infertility Treatment
- 12A The Endometrial Scratch Has Had Its Day
- 12B The Endometrial Scratch Has Had Its Day
- 13A Corticosteroid Therapy Is Useful in Assisting Implantation
- 13B Corticosteroid Therapy Is Useful in Assisting Implantation
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
12A - The Endometrial Scratch Has Had Its Day
For
from Section II - IVF Add-ons
Published online by Cambridge University Press: 25 November 2021
By
Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- 5A DHEA Is an Effective Treatment for Poor Responders
- 5B DHEA Is an Effective Treatment for Poor Responders
- 6A The Addition of LH/hCG to FSH Improves IVF Outcome
- 6B The Addition of LH/hCG to FSH Improves IVF Outcome
- 7A Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 7B Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 8A There Is a Role for Pre-conceptional Treatment with CoQ10
- 8B There Is a Role for Pre-conceptional Treatment with CoQ10
- 9A There Is a Role for Pre-conceptional Treatment with Vitamin D
- 9B There Is a Role for Pre-conception Treatment with Vitamin D
- 10A Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 10B Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 11A Intralipid Therapy Has a Place in Infertility Treatment
- 11B Intralipid Therapy Has a Place in Infertility Treatment
- 12A The Endometrial Scratch Has Had Its Day
- 12B The Endometrial Scratch Has Had Its Day
- 13A Corticosteroid Therapy Is Useful in Assisting Implantation
- 13B Corticosteroid Therapy Is Useful in Assisting Implantation
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
Summary
Endometrial scratching, also known as endometrial injury or trauma, is an add-on suggested to boost the chance of IVF success. Although early evidence appeared to demonstrate a benefit from endometrial scratching in women undergoing IVF, these studies were fraught with methodological issues and associated with a high risk of bias. Despite the poor quality of evidence, endometrial scratching became one of the most popular IVF add-ons in many settings. The procedure is also associated with harms including pain, risk of infection, and a cost of up to US$500. More recent evidence from a large, robust, trial reports no evidence of any benefit from endometrial scratching. Pre-specified subgroup analysis did not reveal any population of women who may benefit. Against a backdrop of only poor-quality research, this new evidence spells the end for endometrial scratching.
- Type
- Chapter
- Information
- 50 Big Debates in Reproductive Medicine , pp. 62 - 64Publisher: Cambridge University PressPrint publication year: 2021
References
Barash, A, Dekel, N, Fieldust, S, Segal, I, Schechtman, E, Granot, I. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril. 2003;79(6):1317–22.CrossRefGoogle Scholar
Nastri, CO, Lensen, SF, Gibreel, A, et al. Endometrial injury in women undergoing assisted reproductive techniques. Cochrane Database of Systematic Reviews 2015, Issue 3.CrossRefGoogle Scholar
Li, W, Suke, S, Wertaschnigg, D, et al. Randomised controlled trials evaluating endometrial scratching: assessment of methodological issues. Hum Reprod. 2019;34(12):2372–80.CrossRefGoogle ScholarPubMed
Mahran, A, Ibrahim, M, Bahaa, H. The effect of endometrial injury on first cycle IVF/ICSI outcome: a randomized controlled trial. Int J Reprod Biomed. 2016;14(3):193–8.Google ScholarPubMed
Lensen, S, Osavlyuk, D, Armstrong, S, et al. A randomized trial of endometrial scratching before in vitro fertilization. N Engl J Med. 2019;24;380(4):325–34.CrossRefGoogle ScholarPubMed