Study co-author Dr Raine-Fenning said: “This is the first well-designed trial conducted into endometrial scratching and the results are promising. Other trials have provided anecdotal evidence, but these have been limited and many questioned the validity of the technique. We are now carrying out a follow up study in Nottingham to provide further guidance into the use of endometrial scratching and early results are encouraging.”
Endometrial scratching, or injury, is defined as medically administered damage to the inner lining of the womb and was first demonstrated as a beneficial procedure in reproductive medicine in 2003.
However ‘scratching’ is an intrusive procedure and many people are still unsure as to how it works or indeed if it definitely does work. Furthermore, optimal timings and protocol for this intervention are yet to be clearly defined.
Up to 15 per cent of women of reproductive age have problems conceiving and reproductive treatment failure is a cause of psychological distress for many couples.
Current attempts to improve reproductive treatments carry significant risks or are not financially viable. This clinical trial strived to determine the optimal timing of this promising intervention, simplifying protocols and minimising the impact to the patient.
158 women were recruited onto the trial, all of whom had previously received unsuccessful courses of reproductive treatment and, critically, were taking an oral contraceptive pill directly before the trial treatment commenced.
77 of these women were randomised to and received the ‘scratching’ intervention, which was administered 7-14 days before core reproductive treatment began, as part of standard pre-treatment gynaecological screening.
39 of the 77 women achieved clinical pregnancy and 33 cases resulted in live births, compared with 23 live births in the control group.
The results of the clinical trial, which were published early online in the leading journal Ultrasound in Obstetrics & Gynecology in September also demonstrated that endometrial scratching had no effect on miscarriage or multiple pregnancy rates compared with standard protocols.
Despite the wide spread use of the technique, the mechanism behind the success of endometrial scratching remains unknown. A plenary talk on the opening day (Sunday October 6) of the ISUOG World Congress in Sydney will address this question.
The study, Endometrial scratching performed in the non-transfer cycle and outcome of assisted reproduction: a randomized controlled trial, was conducted by Dr Raine-Fenning in collaboration with colleagues at the University of Sao Paolo and the Ultrasonography and Retraining Medical School of Ribeiro Preto in Brazil.
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