Levin Dan, Hasson Joseph, Cohen Aviad, Or Yuval, Ata Baris, Barzilay Lilia, Almog Benny
a Department of Obstetrics & Gynecology , IVF Unit, Kaplan Medical Center , Rehovot , Israel (affiliated to the Hebrew University Faculty of Medicine, Jerusalem, Israel).
b Clalit Health Services, Dan Petah-Tikva Region , Ramat Gan , Israel.
Gynecol Endocrinol. 2017 Oct;33(10):779-782. doi: 10.1080/09513590.2017.1318369. Epub 2017 Apr 27.
To assess the effect of endometrial scratching (ES) on in vitro fertilization-embryo transfer outcome (IVF-ET) Materials and methods: Retrospective matched case control study including all fresh IVF cycles performed between January 2006 and December 2012 at an academic IVF center. ES with an endometrial biopsy catheter was performed in the cycle preceding the index IVF cycle. Patients (n = 238) were pair matched with controls according to age, number of previous failed IVF cycles and number of embryos transferred.
Demographic and cycle characteristics were comparable in all of the following: age, number of previous cycles, number of collected oocyte, number of embryos transferred and quality of transferred embryos. Implantation, clinical and ongoing pregnancy rates were comparable in both groups (28%, 34% and 18.4% vs 30%, 40.3% and 29%, in ES group and controls, respectively). Logistic regression analysis found no significant association between ES and pregnancy rate.
Mechanical endometrial stimulation did not improve implantation and pregnancy rates. Furthermore, no factors that may predict which patients could benefit from ES were identified. Further prospective studies are warranted to evaluate possible benefits in different subsets of patients such as patients with recurrent implantation failures.
评估子宫内膜搔刮术(ES)对体外受精-胚胎移植结局(IVF-ET)的影响。材料与方法:回顾性配对病例对照研究,纳入2006年1月至2012年12月在一家学术性体外受精中心进行的所有新鲜IVF周期。在索引IVF周期前一个周期使用子宫内膜活检导管进行ES。根据年龄、既往IVF周期失败次数和移植胚胎数,将患者(n = 238)与对照组进行配对。
以下各项中的人口统计学和周期特征具有可比性:年龄、既往周期数、采集的卵母细胞数、移植胚胎数和移植胚胎质量。两组的着床率、临床妊娠率和持续妊娠率具有可比性(ES组和对照组分别为28%、34%和18.4%,以及30%、40.3%和29%)。逻辑回归分析发现ES与妊娠率之间无显著关联。
机械性子宫内膜刺激并未提高着床率和妊娠率。此外,未发现可预测哪些患者能从ES中获益的因素。有必要进行进一步的前瞻性研究,以评估在不同患者亚组(如反复着床失败患者)中可能的获益情况。