Sarwari Madina, Beilby Kiri, Hammarberg Karin, Hickey Martha, Lensen Sarah
Department of Obstetrics & Gynaecology, Monash University, Melbourne, Australia.
Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Hum Fertil (Camb). 2023 Jul;26(3):599-604. doi: 10.1080/14647273.2021.1995902. Epub 2021 Dec 14.
Endometrial scratching is a common IVF add-on. In 2015, a survey in Australia, New Zealand and the United Kingdom (UK) reported that 83% of fertility specialists recommended endometrial scratching for IVF. Several large trials have since been published reporting no clear evidence for improved live birth rates following endometrial scratching before IVF. An online survey was undertaken to ascertain the current practices and views across Australia, New Zealand, and the UK. A total of 121 eligible responses were received between October and December 2020 (fertility specialists ( = 61), embryologists ( = 26) and fertility nurses ( = 24)). Among fertility specialists, 34% currently offer endometrial scratching, mostly in the case of recurrent implantation failure. Most respondents were neutral or did not believe endometrial scratching improved pregnancy and live birth rates (>90%), except for in women with recurrent implantation failure (29% believed it can increase pregnancy and live birth rates in this group). More than half of respondents viewed reducing psychological distress as a benefit of endometrial scratching (55%). Among fertility specialists not offering endometrial scratching, 51% previously offered it but no longer do. The decline in use over the last five years likely reflects a response to recent evidence reporting no benefit from the procedure.
子宫内膜搔刮术是一种常见的体外受精（IVF）辅助手段。2015年，一项针对澳大利亚、新西兰和英国的调查显示，83%的生殖专家建议在IVF时进行子宫内膜搔刮术。此后，多项大型试验发表，报告称没有明确证据表明IVF前进行子宫内膜搔刮术能提高活产率。开展了一项在线调查，以确定澳大利亚、新西兰和英国目前的做法和观点。2020年10月至12月期间共收到121份合格回复（生殖专家（=61）、胚胎学家（=26）和生殖护士（=24））。在生殖专家中，目前有34%的人提供子宫内膜搔刮术，主要是针对反复种植失败的情况。大多数受访者持中立态度或不认为子宫内膜搔刮术能提高妊娠率和活产率（>90%），反复种植失败的女性除外（29%的人认为这能提高该组女性的妊娠率和活产率）。超过一半的受访者认为减轻心理压力是子宫内膜搔刮术的一个好处（55%）。在不提供子宫内膜搔刮术的生殖专家中，51%的人以前提供过，但现在不再提供了。过去五年中使用量的下降可能反映了对最近报道该手术无益处的证据的回应。
