JSC Baltic Amrican Clinic, 10103 Vilnius, Lithuania.
Vilnius University Hospital Santaros Klinikos, 08661 Vilnius, Lithuania.
Medicina (Kaunas). 2019 Aug 23;55(9):527. doi: 10.3390/medicina55090527.
: Assisted reproductive techniques today have helped many infertile couples achieve their desired pregnancy. However, unsuccessful implantation is usually the key failure in in vitro fertilization cycles. Many factors are now being studied to improve the implantation rate, one being endometrial artificial injury (endometrial scratching). The purpose of this study was to assess whether local endometrial artificial injury improved pregnancy rate, in long agonist and antagonist protocols. : A retrospective analysis was carried out at the JSC Baltic American Clinic from January 1, 2016 to December 31, 2018. Women who were undergoing in vitro fertilization treatment were enrolled in the study. Medical data including demographic factors, menstrual history, and anamnesis of infertility were collected from medical records. Subjects were divided into intervention and control groups. The outcome of this study was clinical pregnancy rate (CPR). : A total of 137 women presenting with primary or secondary infertility were enrolled in the study. Clinical pregnancy was observed in 44/71 (61.9%) patients in the intervention group and 33/66 (50%) in the group without endometrial scratching ( value = 0.16). CPR in the intervention group was significantly higher in the patient group that had undergone ovarian stimulation with a long agonist protocol rather than the antagonist protocol (73.8% vs. 41.4%; value = 0.006). In the multivariable logistic regression model, previously failed in vitro fertilization (IVF) (odds ratio (OR) = 0.07, 95% confidence interval (CI) 0.01-0.47), stimulation with the long agonist protocol (OR = 19.89, 95% CI 3.57-18.63), antagonist protocol (OR = 0.05, 95% CI 0.01-0.34), number of embryos (OR = 1.37, 95% CI 1.05-1.38), and number of blastocysts (OR = 2.96, 95% CI 1.43-8.36) remained important independent prognostic factors for clinical pregnancy. : Our study findings indicate that randomized controlled studies are required to define patients for this procedure and to prove the effect and safety of local endometrial injury, before it is introduced to routine clinical practice.
：今天，辅助生殖技术帮助了许多不孕夫妇实现了他们想要的怀孕。然而，体外受精周期中通常导致失败的关键是胚胎着床不成功。现在有许多因素正在被研究以提高着床率，其中一个因素是子宫内膜人工损伤（子宫内膜搔刮）。本研究旨在评估在长激动剂和拮抗剂方案中，局部子宫内膜人工损伤是否能提高妊娠率。
：这项研究是在 2016 年 1 月 1 日至 2018 年 12 月 31 日期间在 JSC Baltic American Clinic 进行的回顾性分析。接受体外受精治疗的女性被纳入了研究。从病历中收集了包括人口统计学因素、月经史和不孕病史在内的医学数据。研究对象被分为干预组和对照组。本研究的结果是临床妊娠率（CPR）。
：共有 137 名原发性或继发性不孕的女性参与了本研究。在干预组的 71 名患者中，有 44 名（61.9%）观察到临床妊娠，而在未进行子宫内膜搔刮的 66 名患者中，有 33 名（50%）（ 值=0.16）。在接受长激动剂方案而非拮抗剂方案卵巢刺激的患者中，干预组的临床妊娠率显著更高（73.8%比 41.4%； 值=0.006）。在多变量逻辑回归模型中，以前的体外受精失败（OR=0.07，95%置信区间 0.01-0.47）、长激动剂方案刺激（OR=19.89，95%置信区间 3.57-18.63）、拮抗剂方案（OR=0.05，95%置信区间 0.01-0.34）、胚胎数量（OR=1.37，95%置信区间 1.05-1.38）和囊胚数量（OR=2.96，95%置信区间 1.43-8.36）仍然是临床妊娠的重要独立预后因素。
：我们的研究结果表明，需要进行随机对照研究来确定适合这种治疗的患者，并在将局部子宫内膜损伤引入常规临床实践之前，证明其效果和安全性。
