Role of endometrial scratching among recurrent implantation failure patients undergoing in vitro fertilisation/ICSI

Abstract

Aim and Objectives: This article assesses the effect of endometrial scratching on improving rate of implantation in recurrent implantation failure patients and evaluates the potential and safety of endometrial scratching performed once before embryo transfer in women undergoing in vitro fertilisation. Study Design: This was a prospective interventional study. Study Period: This study was conducted from August 2018 to March 2019. Study Setting: Fertility Research Centre. Material and Methods: In this randomised control trial study, 100 patients each with at least two implantation failures were randomly assigned into two groups. In the case group (50 patients), endometrial scratching was performed in mid-luteal phase of the cycle prior to controlled ovarian hyperstimulation with disposable pipelle catheter and embryo transfer (day 3) performed in the next cycle. Clinical pregnancy and implantation rates were compared thereafter. Statistical Analysis: Data were analysed using Social Science System (SPSS) version 17.0 using appropriate statistical tests. Results: Clinical pregnancy was 38% in the scratching group and 30% in the non-scratching group while implantation rate was 15.8% and 11.5% in scratching and non-scratching group, respectively. Conclusion: Endometrial scratching was found to be very safe and a cost-effective technique in women undergoing in vitro fertilisation, and when it was performed in the mid-luteal phase of the previous cycle, it showed increase in chance of clinical pregnancy and implantation rate to some extent. However, as this study was performed on a smaller group, its reliability in clinical practice needs further research by randomised control trials on a larger study group.