The impact of endometrial scratching on the outcome of in vitro fertilization cycles: A prospective study

Objective: Local endometrial trauma (endometrial scratch) is a treatment strategy to improve implantation rates. The objective is to study the relation of endometrial scratching in case of in vitro fertilization. Design: A randomized retrospective study was conducted to know the effects of endometrial scratching on the results of IVF procedure. Materials and Methods: Source of data: This study is undertaken at the International Fertility Centre, New Delhi, with patients with infertility undergoing IVF cycles. Method of collection of data (including sampling procedure if any): All diagnosed cases of primary and secondary infertility requiring IVF are enrolled in the study. A detailed history and clinical evaluation is done. Information is collected in a pretested proforma. Inclusion criteria: All diagnosed cases of primary and secondary infertility requiring self-egg IVF, who came to the OPD of International Fertility Centre, New Delhi. The group in which endometrial scratching preceded the IVF cycle was selected randomly irrespective of socioeconomic status, BMI, or any other factors. The cases and controls were of the same age group. Exclusion criteria: All cases of natural conception or IUI case. Statistical analysis: Following statistical methods are employed in the present study – contingency table analysis and Chi-square test. Results: (1) Endometrial scratching is statistically significant on 1st cycle of IVF outcomes. (2) Success of endometrial scratching in cases of recurrent implantation failure is statistically not significant. (3) Success rate of endometrial scratching in primary infertility cases is statistically not significant. (4) Success rate of endometrial scratching in cases of secondary infertility is statistically not significant. Conclusion: Endometrial scratching is statistically significant on 1st cycle of IVF outcomes. It is postulated that local endometrial injury in stimulated cycles delays endometrial development due to the wound repair process and thereby corrects the asynchrony between the endometrial and embryo stages.