Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy.
Unit of Gynecology and Obstetrics, Department of Women and Children's Health, University of Padua, Padua, Italy.
Fertil Steril. 2019 Apr;111(4):734-746.e2. doi: 10.1016/j.fertnstert.2018.12.008. Epub 2019 Jan 22.
To investigate endometrial scratch injury (ESI) as an intervention to improve IVF outcome in women undergoing a first ET.
Systematic review and meta-analysis.
Not applicable.
PATIENT(S): Infertile women undergoing a first fresh/frozen embryo transfer.
INTERVENTION(S): We included published and unpublished data from randomized controlled trials in which the intervention group received ESI and controls received placebo or no intervention. Pooled results were expressed as relative risk (RR) with 95% confidence interval (CI). The review protocol was registered in PROSPERO to start the data extraction (CRD42018087786).
MAIN OUTCOME MEASURE(S): Ongoing pregnancy/live birth rate (OPR/LBR), clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), miscarriage rate (MR), and ectopic pregnancy rate (EPR).
RESULT(S): Seven studies were included (1,354 participants). We found a nonsignificant difference between groups in terms of OPR/LBR, CPR, MR, MPR, and EPR. Subgroup analysis found that ESI on the day of oocyte retrieval (achieved by a Novak curette) reduced OPR/LBR (RR 0.31, 95% CI 0.14-0.69) and CPR (RR 0.36, 95% CI 0.18-0.71), whereas ESI during the cycle preceding ET (performed through soft devices) had no effect on OPR/LBR and CPR. No difference in the impact of ESI was observed between fresh and frozen embryo transfer.
CONCLUSION(S): Current evidence does not support performing ESI with the purpose of improving the success of a first ET attempt.
研究子宫内膜搔刮损伤（ESI）作为一种干预措施，以改善行首次胚胎移植（ET）的女性的体外受精（IVF）结局。
系统评价和荟萃分析。
不适用。
行首次新鲜/冷冻胚胎移植的不孕女性。
我们纳入了已发表和未发表的随机对照试验数据，其中干预组接受 ESI，对照组接受安慰剂或无干预。汇总结果表示为相对风险（RR）及其 95%置信区间（CI）。该综述方案已在 PROSPERO 中注册，以开始数据提取（CRD42018087786）。
持续妊娠/活产率（OPR/LBR）、临床妊娠率（CPR）、多胎妊娠率（MPR）、流产率（MR）和异位妊娠率（EPR）。
共纳入 7 项研究（1354 名参与者）。我们发现两组间 OPR/LBR、CPR、MR、MPR 和 EPR 无显著差异。亚组分析发现，取卵日（使用 Novak 刮宫器进行）行 ESI 降低了 OPR/LBR（RR 0.31，95%CI 0.14-0.69）和 CPR（RR 0.36，95%CI 0.18-0.71），而在 ET 前周期（使用软性器械进行）行 ESI 对 OPR/LBR 和 CPR 无影响。新鲜和冷冻胚胎移植中 ESI 的影响无差异。
目前的证据不支持为提高首次 ET 尝试的成功率而进行 ESI。
