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子宫内膜搔刮术对接受试管婴儿治疗周期的不孕妇女生殖结局的影响。

The effect of endometrial scratching on reproductive outcomes in infertile women undergoing IVF treatment cycles.

机构信息

Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran.

School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Obstet Gynaecol. 2022 Nov;42(8):3611-3615. doi: 10.1080/01443615.2022.2133995. Epub 2022 Oct 26.

DOI:10.1080/01443615.2022.2133995
PMID:36287634
Abstract

This study was a Randomised Controlled Trial aiming to evaluate the effect of Endometrial Scratching (ES) on fertility rate. Participants were primary infertile women undergoing IVF treatment. ES for the intervention group was done using endometrial aspiration in the luteal phase of the cycle before embryo transfer. In both groups, 2-3 8-celled embryos were transferred after endometrial preparation by Oestrogen and Progesterone. There were no significant differences between the two groups in terms of age, BMI and endometrial thickness (ET). No significant differences were found between intervention and control groups in chemical pregnancy rate ( = 0.410), clinical pregnancy ( = 0.822), the number of abortions ( = 0.282) and the implantation rate ( = 0.777). Local ES had no significant effects in improving the IVF success rate and reducing the embryo abortion rate.Impact statement Endometrial scratching (ES) is a local injury to the endometrium that was assumed to affect implantation in IVF and IUI cycles positively. However, various studies have shown conflicting results on this matter. Local ES had no significant effects on improving the IVF success rate and reducing the embryo abortion rate in patients with the first IVF cycle. Larger clinical trials can measure the usefulness of ES with higher powers. However, this study, along with other clinical trials, can help evaluate the ES effect in future meta-analyses.

摘要

本研究为一项随机对照试验,旨在评估子宫内膜搔刮术(ES)对生育力的影响。参与者为接受体外受精(IVF)治疗的原发性不孕女性。在黄体期,对干预组进行 ES,使用子宫内膜抽吸术,然后在胚胎移植前进行雌激素和孕激素的子宫内膜准备。两组均在子宫内膜准备后移植 2-3 个 8 细胞胚胎。两组在年龄、BMI 和子宫内膜厚度(ET)方面无显著差异。干预组和对照组之间的化学妊娠率( = 0.410)、临床妊娠率( = 0.822)、流产率( = 0.282)和着床率( = 0.777)均无显著差异。局部 ES 对提高 IVF 成功率和降低胚胎流产率没有显著效果。

结论

子宫内膜搔刮术(ES)是一种对子宫内膜的局部损伤,据认为对 IVF 和 IUI 周期的着床有积极影响。然而,关于这个问题的各种研究结果却相互矛盾。对于首次 IVF 周期的患者,局部 ES 对提高 IVF 成功率和降低胚胎流产率没有显著效果。更大规模的临床试验可以用更高的效能来衡量 ES 的有效性。然而,这项研究以及其他临床试验可以帮助在未来的荟萃分析中评估 ES 的效果。

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