Introduction
Endometrial scratching (or injury) is defined as intentional damage to the endometrium. The objective of this study was to investigate the effect of the method of endometrial scratching by hysteroscope or pipelle curette on the outcome of assisted reproduction. Scratching had done in the follicular phase of the preceding cycle to embryo transfer in infertile women aged 20-40 years.
Methods
In this study, 225 ICSI cycles were studied and divided into three groups: - hysteroscope group (75) scratching by scissor, pipelle group (75) scratching by pipelle curette, control group (75) no scratching had done. For each woman in hysteroscope and pipelle groups an appointment was scheduled on day7–14 of the cycle before the planned start of COS to perform endometrial scratching.
Results
There were statistical significant differences between women in the pipelle group, hysteroscope group and control group as regard positive pregnancy test P value = 0.046, clinical pregnancy P value = 0.042, ongoing pregnancy P value = 0.039 and implantation rate P value = 0.044. With further analysis to each intervention group separately with control group, there were statistical significant differences between women in the pipelle group and control group. There was improvement in pregnancy rates in hysteroscope group than control group but with no statistical significant differences.
Conclusion
Endometrial scratching performed in the follicular phase of the preceding cycle to ovarian stimulation by pipelle curette or hysteroscope is associated with improved clinical and ongoing pregnancy rates in infertile women undergoing ICSI