Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-26T03:52:23.586Z Has data issue: false hasContentIssue false

12B - The Endometrial Scratch Has Had Its Day

Against

from Section II - IVF Add-ons

Published online by Cambridge University Press:  25 November 2021

Roy Homburg
Affiliation:
Homerton University Hospital, London
Adam H. Balen
Affiliation:
Leeds Centre for Reproductive Medicine
Robert F. Casper
Affiliation:
Mount Sinai Hospital, Toronto
Get access

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.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barash, A, Dekel, N, Fieldust, S, Segal, I, Schechtman, E, Granot, I. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril. 2003 June;79(6):1317–22.CrossRefGoogle Scholar
Brighton, PJ, Maruyama, Y, Fishwick, K, et al. Clearance of senescent decidual cells by uterine natural killer cells in cycling human endometrium. Elife. 2017 Dec 11;6. pii: e31274.CrossRefGoogle ScholarPubMed
Lensen, S, Venetis, C, Ng, EHY, et al. Should we stop offering endometrial scratching prior to in vitro fertilization? Fertil Steril. 2019 June;111(6):1094–101.CrossRefGoogle ScholarPubMed
Odendaal, J, Quenby, S, Sammaritano, L, Macklon, N, Branch, DW, Rosenwaks, Z. Immunologic and rheumatologic causes and treatment of recurrent pregnancy loss: what is the evidence? Fertil Steril. 2019 Dec;112(6):1002–12.CrossRefGoogle ScholarPubMed
Lensen, S, Osavlyuk, D, Armstrong, S, et al. A randomized trial of endometrial scratching before in vitro fertilization. N Engl J Med. 2019 Jan 24;380(4):325–34.CrossRefGoogle ScholarPubMed
Macklon, NS, Fauser, BCJM. Context-based infertility care. Reprod Biomed Online. 2020;40(1):25.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×