The Role of Endometrial Scratching to Improve the Pregnancy Rate Among Infertile Couples

Awatif Andisha, Ismail Elfortia, Hanan Eljabu, Murjan Elaiwa, Fatma Daw, Hawa Ben-Salah, Hawa Shalfuh, Ruwaydah Mletan, Ibrahim Suliman Hanaish
In: International Journal of Medical Science and Clinical Invention · 2021 · vol. 8(09) , pp. 5639–5644 · doi:10.18535/ijmsci/v8i09.010 · W3201717905
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⚙ AI-generated summary by claude@2026-06, 2026-06-15 ⓘ

This retrospective study found that endometrial scratching improved clinical pregnancy rates in infertile women with secondary infertility or previous failed ICSI cycles, but did not significantly affect live birth rates.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-15 · read from full text ⓘ

This retrospective study from the Libyan National Fertility Centre evaluated endometrial scratching (ES) in 188 infertile women randomized into an ES group (n=95) and a control group (n=93), excluding male factor infertility, prior surgical sterilization, premature ovarian failure, endometriosis, and other hormonal disturbances. ES was associated with a statistically significant improvement in clinical pregnancy rate overall, with additional benefits reported in secondary infertile patients and in those with a previous failed ICSI cycle. The study found no statistically significant difference in live birth rate. This paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index (endometriosis was an exclusion criterion).

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Abstract

Background: Different technologies have been used in order to improve the endometrial condition as well as the quality of embryos; however, still the implantation process could fail. Endometrial Scratching (ES) has been proposed by many studies and revealed conflicting results. Objective: The study Aims to investigate the effect of ES on improving the Clinical Pregnancy Rate (CPR) and Live Birth Rate (LBR). Methodology: This is a retrospective study was carried out at Libyan National Fertility Centre. 188 Infertile women were included in the study in two different groups. 95 patients who underwent ES and 93 as control group. Cases with male factor infertility, history of surgical sterilization, premature ovarian failure, endometriosis and other hormonal disturbance (thyroid /prolactin) had been excluded from the study. Results: The CPR was positively affected by scratching procedure among infertile women after perform ES (p value 0.022). The secondary infertile patients have got significant benefit after performing ES by improving the CPR (P value 0.045). The ES has improved the CPR on patients with previous history of failed Intra-Cytoplasmic Semen Injection ICSI (P value 0.043). However, there was no statistically significant difference to the effect of ES on LBR. Conclusion: The study found that the ES has a positive role to improve the implantation among specific group of infertile couples. It is recommended to perform ES for couples with secondary infertility and previously failed ICSI cycle.
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Abstract

Background: Different technologies have been used in order to improve the endometrial condition as well as the quality of embryos; however, still the implantation process could fail. Endometrial Scratching (ES) has been proposed by many studies and revealed conflicting results.

Objective

The study Aims to investigate the effect of ES on improving the Clinical Pregnancy Rate (CPR) and Live Birth Rate (LBR). Methodology: This is a retrospective study was carried out at Libyan National Fertility Centre. 188 Infertile women were included in the study in two different groups. 95 patients who underwent ES and 93 as control group. Cases with male factor infertility, history of surgical sterilization, premature ovarian failure, endometriosis and other hormonal disturbance (thyroid /prolactin) had been excluded from the study.

Results

The CPR was positively affected by scratching procedure among infertile women after perform ES (p value 0.022). The secondary infertile patients have got significant benefit after performing ES by improving the CPR (P value 0.045). The ES has improved the CPR on patients with previous history of failed Intra-Cytoplasmic Semen Injection ICSI (P value 0.043). However, there was no statistically significant difference to the effect of ES on LBR.

Conclusion

The study found that the ES has a positive role to improve the implantation among specific group of infertile couples. It is recommended to perform ES for couples with secondary infertility and previously failed ICSI cycle.

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endometriosisinfertility

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