Is Hysteroscopic Endometrial Scratching Affect Outcome of Intracytoplasmic Sperm Injection in Women with Primary Infertility?

A.Y.Rezk1, M.F.Elsherbiny1, K.M.Salama1, I.I.Souidan1 and M.M.Abd El-Menaem2"


Implantation rate per embryo transferred usually does not exceed 30%, although higher rates with use of blastocysts have been reported, depending on age. Successful implantation depends on development of high-quality embryos and the acquisition of endometrial receptivity. Implantation failure is attributed to the failure of uterus to acquire receptivity. Implantation failure remains a major factor limiting success in vitro fertilization (IVF) treatment. Mechanical manipulation of the endometrium can enhance receptivity by modulating gene expression of factors required for implantation like glycodelin A, laminin alpha 4, integrin alpha 6 and matrix metalloproteinase 1.Value of hysteroscopic endometrial scratching in improving pregnancy rates in patient undergoing ICSI in the next cycle in a randomized controlled study.The study was carried out at the Benha Fertility Centre, including 91 infertile patients as eligible cases for the study and recruited for hysteroscopic endometrial scratching in early follicular phase of the cycle between the 7th and 11th day of the cycle and 91 women as a control group without endometrial scratching.Our results had showed non-significant differences between case group and control group regarding age, body mass index and duration. There were non-significant differences between interventional group and non-interventional group regarding number of follicles, number of oocytes retrieved, number of embryos, endometrial thickness, pregnancy rate, implantation rate and ongoing pregnancy and a high significant difference between the two studied groups regarding microbiota. Endometrial scratching does not result in improving clinical pregnancy rates and implantation rate in the subsequent IVF-ET in women with primary infertility.

Key words

Hysteroscopy, Implantation, Fertilizaion, Implantation Failure, Hysteroscopy, Endometrial Scratching.