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Journal of Assisted Reproduction and Genetics

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27.05.2017 | Assisted Reproduction Technologies

Pregnancy after endometrial scratching in infertile couples undergoing ovulation induction and intrauterine insemination cycles—a randomized controlled trial

verfasst von: Tuhina Goel, Reeta Mahey, Neerja Bhatla, Mani Kalaivani, Sangeeta Pant, Alka Kriplani

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 8/2017

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Abstract

Purpose

To study the effect of endometrial scratching in infertile couples undergoing ovulation induction and intrauterine insemination (IUI) cycles.

Methods

A prospective randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India. One hundred forty-four women with primary/secondary infertility were recruited. Couples were either unexplained or male factor infertility. Subjects were randomized into intervention (scratching) and control group. All patients received ovulation induction with clomiphene citrate (day 2–6) 50 mg/day +75 IU HMG on days 6 and 7. In addition, endometrial scratching was done on day 8 of ovulation induction cycle in intervention group. All couples were planned for three cycles of ovulation induction and IUI over 6 months. After each failed cycle, couple was advised to try for natural conception for one cycle. Those who conceived were excluded from further analysis. Primary outcome was clinical pregnancy rate. Secondary outcome measures included conception rate, ongoing pregnancy, abortion and ectopic rate.

Results

Baseline characteristics were comparable in both groups. Clinical pregnancy rate was significantly higher in intervention group (31.9%; 23/72) as compared to control group (16.7%; 12/72) (p value 0.030). On per cycle analysis, first IUI cycle had significantly high pregnancy rate (18.1%; 13/72) as compared to control group (5.6%; 4/72). Three patients in intervention group and one in control group conceived in wash out cycle. Ongoing pregnancy rate was significantly higher in scratching group (30.0%; 21/70) as compared to control group (15.7%; 11/70) (p value0.044).

Conclusions

Endometrial scratching can be used as a low cost-effective tool to improve clinical pregnancy and ongoing pregnancy rate in IUI cycles. Further large number studies are required to document its role in improving live birth rate.

Trial registration number

CTRI/2015/12/006419

Dekel N, Gnainsky Y, Granot I, Mor G. Inflammation and implantation. Am J Reprod Immunol. 2010;63:17–21.CrossRefPubMedPubMedCentral

Quaas A, Dokras A. Diagnosis and treatment of unexplained infertility. Rev Obstet Gynecol. 2008;1(2):69–76.PubMedPubMedCentral

Finn CA, Martin L. Endocrine control of the timing of endometrial sensitivity to a decidual stimulus. Biol Reprod. 1972;7(1):82–6.CrossRefPubMed

Mirkin S, Arslan M, Churikov D, Corica A, Diaz J, Williams S, Bocca S, Oehninger S. In search of candidate genes critically expressed in the human endometrium during the window of implantation. Hum Reprod. 2005;20:2104–17.CrossRefPubMed

Zhou L, Li R, Wang R, Huang H, Zhong K. Local injury to the endometrium in controlled ovarian hyper stimulation cycles improves implantation rates. Fertil Steril. 2008;89:1166–76.CrossRefPubMed

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;79:1317–22.CrossRefPubMed

Gnainsky Y, Granot I, Aldo PB, Barash A, Or Y, Schechtman E, et al. Local injury of the endometrium induces an inflammatory response that promotes successful implantation. Fertil Steril. 2010;94:2030–6.CrossRefPubMedPubMedCentral

Raziel A, Schachter M, Strassburger D, Berno O, Ron-El R, Friedler S. Favorable influence of local injury to the endometrium in intracytoplasmic sperm injection in patients with high-order implantation failure. Fertil Steril. 2007;87:198–201.CrossRefPubMed

Karimzadeh MA, Ayazi Rozbahani M, Tabibnejad N. Endometrial local injury improves the pregnancy rate among recurrent implantation failure patients undergoing in vitro fertilisation/intra cytoplasmic sperm injection: a randomised clinical trial. Aust N Z J Obstet Gynaecol. 2009;49:677–80.CrossRefPubMed

10.

Tiboni GM, Giampietro F, Gabriele E, Di Donato V, Impicciatore GG. Impact of a single endometrial injury on assisted reproductive technology outcome: a preliminary observational study. J Reprod Med. 2011;56:504–6.PubMed

11.

Zepnep IO, Gorkemli H, Hasan IA. The effect of local injury to the endometrium for implantation and pregnancy rates in ICSI-ET cycles with implantation failure. Eur J Gen Med. 2012;9:223–9.

12.

Zhou L, Li R, Wang R, Huang HX, Zhong K. Local injury to the endometrium in controlled ovarian hyperstimulation cycles improves implantation rates. Fertil Steril. 2008;89:1166–76.CrossRefPubMed

13.

Li R, Gui Y, Lu L, Hao G, Cai Z. Local injury to the endometrium improves the pregnancy rate in patients undergoing in vitro fertilisation. Int Cong Ser. 2004;1271:73–6.CrossRef

14.

Bonavita M, Mattila M, Ferreira F, Maia-Filho V, Rocha A, Serafini P, et al. Local endometrial injury/healing increases embryo implantation and pregnancy rates of in vitro fertilization treatments. Hum Reprod. 2011;26:205–6.

15.

Guven S, Kart C, Unsal M, Yildirim O, Odaci E, Yulug E. Endometrial injury may increase the clinical pregnancy rate in normoresponders who underwent long agonist protocol intracytoplasmic sperm injection cycles with single embryo transfer. Eur J Obstet Gynecol Reprod Biol. 2014;173:58–62.CrossRefPubMed

16.

Nastri CO, Ferriani RA, Raine-Fenning N, Martins WP. Endometrial scratching performed in the non-transfer cycle and outcome of assisted reproduction: a randomized controlled trial. Ultrasound Obstet Gynecol. 2013;42:375–82.CrossRefPubMed

17.

Abdelhamid AM. The success rate of pregnancy in IUI cycles following endometrial sampling. A randomized controlled study: endometrial sampling and pregnancy rates. Arch Gynecol Obstet. 2013;288:673–8.CrossRefPubMed

18.

Soliman B, Harira M. Local endometrial scratching under ultrasound guidance after failed intrauterine insemination and cycle outcome: a randomized controlled trial. Middle East Fertility Society Journal. 2017;22:60–6.CrossRef

19.

Zarei A, Alborzi S, Dadras N, Azadi G. The effects of endometrial injury on intrauterine insemination outcome: a randomized clinical trial. Iran J Reprod Med. 2014;12:649–52.PubMedPubMedCentral

20.

El-Khayat W, Elsadek M, Saber W. Comparing the effect of office hysteroscopy with endometrial scratch versus office hysteroscopy on intrauterine insemination outcome: a randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2015;194:96–100.

21.

Wadhwa L, Pritam A, Gupta T, Gupta S, Arora S, Chandoke R. Effect of endometrial biopsy on intrauterine insemination outcome in controlled ovarian stimulation cycle. J Hum Reprod Sci. 2015;8:151–8.CrossRefPubMedPubMedCentral

22.

Maged AM, Al-Inany H, Salama KM, Souidan II, Abo Ragab HM, Elnassery N. Endometrial scratch injury induces higher pregnancy rate for women with unexplained infertility undergoing IUI with ovarian stimulation: a randomized controlled trial. Reprod Sci. 2016;23(2):239–43.CrossRefPubMed

23.

Parsanezhad ME, Dadras N, Maharlouei N, Neghahban L, Keramati P, Amini M. Pregnancy rate after endometrial injury in couples with unexplained infertility: a randomized clinical trial. Iran J Reprod Med. 2013;11:869–74.PubMedPubMedCentral

24.

Lensen S, Martins W, Nastri C, Sadler L, Farquhar C. Pipelle for pregnancy (PIP): study protocols for three randomised controlled trials. Trials. 2016;17:216.CrossRefPubMedPubMedCentral

25.

Kalma Y, Granot I, Gnainsky Y, Or Y, Czernobilsky B, Dekel N, et al. Endometrial biopsy-induced gene modulation: first evidence for the expression of bladder-transmembranal uroplakin Ib in human endometrium. Fertil Steril. 2009;91:1042–9.CrossRefPubMed

Titel: Pregnancy after endometrial scratching in infertile couples undergoing ovulation induction and intrauterine insemination cycles—a randomized controlled trial
verfasst von: Tuhina Goel
Reeta Mahey
Neerja Bhatla
Mani Kalaivani
Sangeeta Pant
Alka Kriplani
Publikationsdatum: 27.05.2017
Verlag: Springer US
Erschienen in: Journal of Assisted Reproduction and Genetics / Ausgabe 8/2017
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-017-0949-8

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Pregnancy after endometrial scratching in infertile couples undergoing ovulation induction and intrauterine insemination cycles—a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusions

Trial registration number

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Abstract

Purpose

Methods

Results

Conclusions

Trial registration number

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