Role of Endometrial Scratching in Implantation Failures

Objective: To assess the role of endometrial scratching in implantation failure cases. Design: Retrospective analysis. Materials and Methods: 60 infertile females with at least one IVF failure in the age group of 23 to 35 years were evaluated in a period of 6 months. In the group 1 of 30 females, endometrial scratching was done between Day 21 to 25 of previous periods and in the group 2 of 30 females, endometrial scratching was not done. Controlled ovarian stimulation (COH) was started from day 2 of next period in all subjects with the antagonist protocol. Transvaginal guided oocyte aspiration was done. Day 3 embryo transfer was performed in all subjects. Results: There was no difference between the two groups regarding demographic variables, egg reserve, sperm parameters, number of embryos transferred and embryo quality. The pregnancy rate was 40% (12 out of 30 cases) in the group 1 that was similar to 36.7% in the group 2 (11 out of 30 cases). The clinical pregnancy rate was 36.7% (11 out of 30 cases) in the group 1 that was similar to 33.3% in the group 2 (10 out of 30 cases). Conclusions: The local injury caused by endometrial scratching though result in local inflammation and angiogenic environment in uterus but it does not improve the pregnancy rate. Further studies are needed to prove the efficacy of endometrial scratching with larger sample size. This is one of the few studies done in South Asia that showed scratching has no role in implantation failure.