1. Endometrial scratching in women with one failed IVF/ICSI cycle - outcomes of a randomised controlled trial (SCRaTCH)
- Author
-
van Hoogenhuijze, NE, Mol, F (Femke), Laven, Joop, Groenewoud, ER, Traas, MAF, Janssen, CAH, Teklenburg, G, Bruin, JP, van Oppenraaij, R, Maas, JWM, Moll, E, Fleischer, K, van Hooff, MH, de Koning, CH, Cantineau, AEP, Lambalk, CB, Verberg, M, Heusden, AM, Manger, AP, van Rumste, MME, van der Voet, LF, Pieterse, QD, Visser, J, Brinkhuis, EA, den Hartog, JE, Glas, MW, Klijn, NF, van Meer, S, Bandell, ML, Boxmeer, JC, van Disseldorp, J, Smeenk, J, van Wely, M, Eijkemans, MJC, Torrance, HL, Broekmans, FJ, van Hoogenhuijze, NE, Mol, F (Femke), Laven, Joop, Groenewoud, ER, Traas, MAF, Janssen, CAH, Teklenburg, G, Bruin, JP, van Oppenraaij, R, Maas, JWM, Moll, E, Fleischer, K, van Hooff, MH, de Koning, CH, Cantineau, AEP, Lambalk, CB, Verberg, M, Heusden, AM, Manger, AP, van Rumste, MME, van der Voet, LF, Pieterse, QD, Visser, J, Brinkhuis, EA, den Hartog, JE, Glas, MW, Klijn, NF, van Meer, S, Bandell, ML, Boxmeer, JC, van Disseldorp, J, Smeenk, J, van Wely, M, Eijkemans, MJC, Torrance, HL, and Broekmans, FJ
- Abstract
STUDY QUESTION: Does endometrial scratching in women with one failed IVF/ICSI treatment affect the chance of a live birth of the subsequent fresh IVF/ICSI cycle? SUMMARY ANSWER: In this study, 4.6% more live births were observed in the scratch group, with a likely certainty range between -0.7% and +9.9%. WHAT IS KNOWN ALREADY: Since the first suggestion that endometrial scratching might improve embryo implantation during IVF/ICSI, many clinical trials have been conducted. However, due to limitations in sample size and study quality, it remains unclear whether endometrial scratching improves IVF/ICSI outcomes. STUDY DESIGN, SIZE, DURATION: The SCRaTCH trial was a non-blinded randomised controlled trial in women with one unsuccessful IVF/ICSI cycle and assessed whether a single endometrial scratch using an endometrial biopsy catheter would lead to a higher live birth rate after the subsequent IVF/ICSI treatment compared to no scratch. The study took place in 8 academic and 24 general hospitals. Participants were randomised between January 2016 and July 2018 by a web-based randomisation programme. Secondary outcomes included cumulative 12-month ongoing pregnancy leading to live birth rate. PARTICIPANTS/MATERIALS, SETTING, METHODS: Women with one previous failed IVF/ICSI treatment and planning a second fresh IVF/ICSI treatment were eligible. In total, 933 participants out of 1065 eligibles were included (participation rate 88%). MAIN RESULTS AND THE ROLE OF CHANCE: After the fresh transfer, 4.6% more live births were observed in the scratch compared to control group (110/465 versus 88/461, respectively, risk ratio (RR) 1.24 [95% CI 0.96-1.59]). These data are consistent with a true difference of between -0.7% and +9.9% (95% CI), indicating that while the largest proportion of the 95% CI is positive, scratching could have no or even a small negative effect. Biochemical pregnancy loss and miscarriage rate did not differ between the two groups: In the scratch group 27/1
- Published
- 2021