TY - JOUR
T1 - A Randomized trial of endometrial scratching before in vitro fertilization
AU - Lensen, Sarah
AU - Osavlyuk, Diana
AU - Armstrong, Sarah
AU - Stadelmann, Caroline
AU - Hennes, Aurelié
AU - Napier, Emma
AU - Wilkinson, Jack
AU - Sadler, Lynn
AU - Gupta, Devashana
AU - Strandell, Annika
AU - Bergh, Christina
AU - Vigneswaran, Kugajeevan
AU - Teh, Wan
AU - Hamoda, Haitham
AU - Webber, Lisa
AU - Wakeman, Sarah
AU - Searle, Leigh
AU - Bhide, Priya
AU - McDowell, Simon
AU - Peeraer, Karen
AU - Khalaf, Yacoub
AU - Farquhar, Cynthia
N1 - Funding Information:
Supported by the University of Auckland, New Zealand; the A+ Trust, Auckland District Health Board, New Zealand; the Nurture Foundation, New Zealand; and the Maurice and Phyllis Paykel Trust, New Zealand.
Publisher Copyright:
© 2019 Massachusetts Medical Society.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019
Y1 - 2019
N2 - BACKGROUND Endometrial scratching (with the use of a pipelle biopsy) is a technique proposed to facilitate embryo implantation and increase the probability of pregnancy in women undergoing in vitro fertilization (IVF). METHODS We conducted a pragmatic, multicenter, open-label, randomized, controlled trial. Eligible women were undergoing IVF (fresh-embryo or frozen-embryo transfer), with no recent exposure to disruptive intrauterine instrumentation (e.g., hysteroscopy). Participants were randomly assigned in a 1:1 ratio to either endometrial scratching (by pipelle biopsy between day 3 of the cycle preceding the embryotransfer cycle and day 3 of the embryo-Transfer cycle) or no intervention. The primary outcome was live birh. RESULTS A total of 1364 women underwent randomization. The frequency of live birth was 180 of 690 women (26.1%) in the endometrial-scratch group and 176 of 674 women (26.1%) in the control group (adjusted odds ratio, 1.00; 95% confidence interval, 0.78 to 1.27). There were no significant between-group differences in the rates of ongoing pregnancy, clinical pregnancy, multiple pregnancy, ectopic pregnancy, or miscarriage. The median score for pain from endometrial scratching (on a scale of 0 to 10, with higher scores indicating worse pain) was 3.5 (interquartile range, 1.9 to 6.0). CONCLUSIONS Endometrial scratching did not result in a higher rate of live birth than no intervention among women undergoing IVF. (Funded by the University of Auckland and others; PIP Australian New Zealand Clinical Trials Registry number, ACTRN12614000626662,
AB - BACKGROUND Endometrial scratching (with the use of a pipelle biopsy) is a technique proposed to facilitate embryo implantation and increase the probability of pregnancy in women undergoing in vitro fertilization (IVF). METHODS We conducted a pragmatic, multicenter, open-label, randomized, controlled trial. Eligible women were undergoing IVF (fresh-embryo or frozen-embryo transfer), with no recent exposure to disruptive intrauterine instrumentation (e.g., hysteroscopy). Participants were randomly assigned in a 1:1 ratio to either endometrial scratching (by pipelle biopsy between day 3 of the cycle preceding the embryotransfer cycle and day 3 of the embryo-Transfer cycle) or no intervention. The primary outcome was live birh. RESULTS A total of 1364 women underwent randomization. The frequency of live birth was 180 of 690 women (26.1%) in the endometrial-scratch group and 176 of 674 women (26.1%) in the control group (adjusted odds ratio, 1.00; 95% confidence interval, 0.78 to 1.27). There were no significant between-group differences in the rates of ongoing pregnancy, clinical pregnancy, multiple pregnancy, ectopic pregnancy, or miscarriage. The median score for pain from endometrial scratching (on a scale of 0 to 10, with higher scores indicating worse pain) was 3.5 (interquartile range, 1.9 to 6.0). CONCLUSIONS Endometrial scratching did not result in a higher rate of live birth than no intervention among women undergoing IVF. (Funded by the University of Auckland and others; PIP Australian New Zealand Clinical Trials Registry number, ACTRN12614000626662,
U2 - 10.1056/NEJMoa1808737
DO - 10.1056/NEJMoa1808737
M3 - Article
SN - 1533-4406
VL - 380
SP - 325
EP - 334
JO - New England Journal of Medicine|N E J M
JF - New England Journal of Medicine|N E J M
IS - 4
M1 - 380
ER -
