Book contents
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- 5A DHEA Is an Effective Treatment for Poor Responders
- 5B DHEA Is an Effective Treatment for Poor Responders
- 6A The Addition of LH/hCG to FSH Improves IVF Outcome
- 6B The Addition of LH/hCG to FSH Improves IVF Outcome
- 7A Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 7B Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 8A There Is a Role for Pre-conceptional Treatment with CoQ10
- 8B There Is a Role for Pre-conceptional Treatment with CoQ10
- 9A There Is a Role for Pre-conceptional Treatment with Vitamin D
- 9B There Is a Role for Pre-conception Treatment with Vitamin D
- 10A Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 10B Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 11A Intralipid Therapy Has a Place in Infertility Treatment
- 11B Intralipid Therapy Has a Place in Infertility Treatment
- 12A The Endometrial Scratch Has Had Its Day
- 12B The Endometrial Scratch Has Had Its Day
- 13A Corticosteroid Therapy Is Useful in Assisting Implantation
- 13B Corticosteroid Therapy Is Useful in Assisting Implantation
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
12B - The Endometrial Scratch Has Had Its Day
Against
from Section II - IVF Add-ons
Published online by Cambridge University Press: 25 November 2021
- 50 Big Debates in Reproductive Medicine
- Series page
- 50 Big Debates in Reproductive Medicine
- Copyright page
- Contents
- Contributors
- Foreword
- Introduction
- Section I Limits for IVF
- Section II IVF Add-ons
- 5A DHEA Is an Effective Treatment for Poor Responders
- 5B DHEA Is an Effective Treatment for Poor Responders
- 6A The Addition of LH/hCG to FSH Improves IVF Outcome
- 6B The Addition of LH/hCG to FSH Improves IVF Outcome
- 7A Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 7B Acupuncture Is a Useful Adjuvant for Fertility Treatment
- 8A There Is a Role for Pre-conceptional Treatment with CoQ10
- 8B There Is a Role for Pre-conceptional Treatment with CoQ10
- 9A There Is a Role for Pre-conceptional Treatment with Vitamin D
- 9B There Is a Role for Pre-conception Treatment with Vitamin D
- 10A Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 10B Natural Killer Cell Assay in the Blood Is a Useless Investigation
- 11A Intralipid Therapy Has a Place in Infertility Treatment
- 11B Intralipid Therapy Has a Place in Infertility Treatment
- 12A The Endometrial Scratch Has Had Its Day
- 12B The Endometrial Scratch Has Had Its Day
- 13A Corticosteroid Therapy Is Useful in Assisting Implantation
- 13B Corticosteroid Therapy Is Useful in Assisting Implantation
- Section III The Best Policy
- Section IV Embryology
- Section V Ethics and Statistics
- Section VI Male-factor Infertility
- Section VII Genetics
- Section VIII Ovarian Stimulation
- Section IX Hormones and the Environment
- Index
- References
Summary
The endometrial scratch has become a popular intervention in IVF, particularly in the management of patients presenting with recurrent implantation failure. However, randomised controlled trials that fail to show any benefit on clinical outcomes have recently been published. Given the invasive nature and uncertain putative mechanism of action, there is now a narrative that it should no longer be part of the therapeutic repertoire. In this article, the debate is not about whether the scratch should be used in routine clinical practice: there is enough convincing evidence to indicate it should not. What is challenged is the notion that the studies thus far performed allow the conclusion to be drawn that it will not be of value to any patient and has therefore ‘had its day’. A case is made for a different approach to assessing the efficacy of interventions in the management of recurrent implantation failure.
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- 50 Big Debates in Reproductive Medicine , pp. 65 - 67Publisher: Cambridge University PressPrint publication year: 2021