Journal Article10.1016/J.RBMO.2021.10.008
A Randomised Trial of Endometrial Scratching in Women with Polycystic Ovary Syndrome undergoing Ovulation Induction cycles
Glanville Elizabeth Joan,Wilkinson Jack,Sadler Lynn,Wong Tze Yoong,Acharya Santanu,Aziz Nabil,Clarke Fiona,Das Sangeeta,Dawson Jeanette,Hammond Bev,Jayaprakasan Kanna,Milner Matthew,Shankaralingaiah Nethra,Farquhar Cynthia,Lensen Sarah,Lensen Sarah +15 more
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TL;DR: In this paper, the authors evaluated whether endometrial scratch improved the chance of a live birth in women with PCOS undergoing ovulation induction and trying to conceive, and they did not detect a difference in live birth rate.
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Abstract: Research Question To evaluate whether endometrial scratch improved the chance of a live birth in women with PCOS undergoing ovulation induction and trying to conceive. Design An international, multicentre, randomised, sham-controlled trial across six fertility clinics in three countries (New Zealand, United Kingdom and Brazil). Women with a diagnosis of PCOS who were planning to commence ovulation induction cycles (at least three cycles) in order to conceive were randomly assigned to receive the pipelle (scratch) procedure or a sham (placebo) procedure in the first cycle of ovulation induction. Women kept a diary of ovulation induction and sexual intercourse timing over three consecutive cycles and pregnancies were followed-up to live birth. Primary outcome was live birth and secondary outcomes were clinical pregnancy, ongoing pregnancy, multiple pregnancy, adverse pregnancy outcomes, neonatal outcomes, bleeding following procedure and pain score following procedure. Results 117 women were randomised; 58 to the scratch group and 59 to the sham group. Live birth occurred in 11 (19%) women in the scratch group and 14 (24%) in the sham group (OR 0.76, 95% confidence interval of 0.30 to 1.92). Secondary outcomes were similar in each group. Significantly higher pain scores were reported in the scratch group (adjusted mean difference 3.2, 95% confidence interval of 2.5 to 3.9) when measured on a visual-analogue scale. Conclusion We did not detect a difference in live birth rate for women with PCOS who received an endometrial scratch when trying to conceive using ovulation induction, however, uncertainty remains due to the small sample size in our study.
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Citations
Endometrial Scratching for Improving Endometrial Receptivity: a Critical Review of Old and New Clinical Evidence
TL;DR: A critical analysis of the old and new available evidence is provided to assist physicians interpreting the published data, and to generate insights for future research on the topic.
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Pharmacological and non-pharmacological interventions for improving endometrial receptivity in infertile patients with polycystic ovary syndrome: a comprehensive review of the available evidence
Stefano Palomba,Flavia Costanzi,Donatella Caserta,Amerigo Vitagliano +3 more
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Is endometrial receptivity impaired in women with polycystic ovary syndrome?
TL;DR: In this article , the main and recent experimental and clinical data will discuss in order to clarify the role played by the endometrium in the PCOS-related subfertility.
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Fertility specialists’ views, behavior, and attitudes towards the use of endometrial scratching in Italy
Stefano Palomba,Domenico Carone,Amerigo Vitagliano,Flavia Costanzi,Alice Fracassi,Tiziana Russo,Serena Del Negro,Altiero Biello,Annalisa Di Filippo,Antonio Mangiacasale,Antonio Di Monaco,Antonio Ranieri,Beatrice Ermini,Bruno Francesco Barba,Claudio Castello,Federica Di Guardo,Francesco Pastorella,Elena Bernasconi,Ezio Michele Tricarico,Francesca Filippi,Francesco Polsinelli,Giuseppe Lo Monte,Loredana Maria Sosa Fernandez,Marco Aurélio Knippel Galletta,Paolo Giardina,Pasquale Totaro,Roberto Laganara,Roberto Liguori,Matteo Buccheri,Mario Montanino Oliva,Roberto Piscopo,Assunta Iuliano,Nicola Innantuoni,I. Romanello,Francesco Sinatra,Annalisa Liprino,Roberto Thiella,Alessandra Tiezzi,T. Bartolotti,Alessandra Tomasi,Valeria Finocchiaro,Mario Thiella,Giuseppa Fuggetta,Sebastiano Messineo,Francesco Isabella,Marcello Tripodi,Stefania Iaccarino,Giovanni Battista La Sala,Enrico Papaleo,Donatella Caserta,Roberto Marci,Edgardo Somigliana,Antonino Guglielmino +52 more
TL;DR: Fertility specialists in Italy have a low utilization and poor information quality regarding endometrial scratching procedures.
Reply of the authors: is the era of the endometrial scratching finished?
TL;DR: In this paper , the authors respond to the letter entitled "Is the era of the endometrial scratching finished?" related to our study published in Fertility and Sterility (1).
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