Endometrial "Scratching" An update and overview of current research

Abstract

About one in every six couples is affected by sterility. Assisted reproduction procedures are currently the treatment of choice for a number of patients who desire children. Many causes of sterility can be overcome with the aid of in vitro fertilization, but successful implantation of the embryos is the major limiting factor. Failure of implantation may occur repetitively. In the treatment of sterility, many approaches have been used to overcome the barrier of implantation failure and improve the chances of successful nidation. Scratching the endometrium prior to embryo transfer has been suggested as one means of enhancing the likelihood of implantation. The current literature was examined to investigate if there was any possible benefit from endometrial scratching. The studies were divided according to whether the women suffered from recurrent implantation failure or not. In summary, it was found that unselected subfertile women generally benefit less from endometrial scratching, but scratching appears to be successful in women who have experienced repeated implantation failure. Although the heterogeneous body of data on the subject deserves further clarification. The latest data presented at "European Society of Human Reproduction and Embryology" 2018 in Barcelona suggested that the method should be abandoned.

Keywords: Infertility; perinatal immunology and inflammation; reproductive immunology.

Figure 1

Hysteroscopy Hysteroscopic view of an inconspicuous cavum uteri. In the middle of the picture the thrown-up endometrium is shown and in the rear part the exit of the right tube can be seen

Figure 2

a, b, c) Endometrial scratching For immunomodulatory stimulation, a mucosal lesion is created usually on the posterior wall with the hysteroscope