Seval Mehmet Murat, Şükür Yavuz Emre, Özmen Batuhan, Kan Özgür, Sönmezer Murat, Berker Bülent, Atabekoğlu Cem
a Department of Obstetrics and Gynecology , Center for Research on Human Reproduction, Ankara University School of Medicine , Ankara , Turkey.
Gynecol Endocrinol. 2016 Dec;32(12):957-960. doi: 10.1080/09513590.2016.1190818. Epub 2016 Jun 3.
To investigate the effect of additional endometrial scratching procedure during hysteroscopy on assisted reproductive technology (ART) cycle outcomes in repeated implantation failure (RIF) patients without endometrial or uterine abnormalities on hysteroscopic evaluation.
Three hundred and forty-five RIF patients who underwent ART at a university-based infertility clinic between January 2011 and June 2015 were recruited in this retrospective cohort study. Uterine cavities of all included patients were evaluated by diagnostic hysteroscopy 7-14 days prior to the subsequent ART cycle. Women without endometrial abnormalities were allocated into two groups; the scratching group was consisted of patients who underwent endometrial scratching by using monopolar electric energy with needle forceps during hysteroscopy, and the control group was consisted of patients who underwent only diagnostic hysteroscopy.
The implantation rate was significantly higher in the scratching group than the control group (37.7% versus 24.5%; p = 0.04). Clinical and ongoing pregnancy rates were also found to be significantly higher in the scratching group than the control group (37.7% versus 27.6%; p = 0.03; and 33.3% versus 23%; p = 0.03, respectively).
Endometrial scratching during diagnostic hysteroscopy seems to enhance implantation and as well pregnancy rates in comparison to diagnostic hysteroscopy alone.
探讨宫腔镜检查时附加子宫内膜搔刮术对宫腔镜评估无子宫内膜或子宫异常的反复种植失败（RIF）患者辅助生殖技术（ART）周期结局的影响。
本回顾性队列研究纳入了2011年1月至2015年6月在一所大学附属医院不孕不育门诊接受ART的345例RIF患者。所有纳入患者在随后ART周期前7 - 14天接受诊断性宫腔镜检查以评估子宫腔情况。无子宫内膜异常的女性被分为两组；搔刮组由在宫腔镜检查时使用单极电能和针状钳进行子宫内膜搔刮的患者组成，对照组由仅接受诊断性宫腔镜检查的患者组成。
搔刮组的种植率显著高于对照组（37.7%对24.5%；p = 0.04）。还发现搔刮组的临床妊娠率和持续妊娠率也显著高于对照组（分别为37.7%对27.6%；p = 0.03；以及33.3%对23%；p = 0.03）。
与单纯诊断性宫腔镜检查相比，诊断性宫腔镜检查时进行子宫内膜搔刮似乎可提高种植率及妊娠率。
