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Use of endometrial scratching in IVF/IUI

Since the first publication by Barash et al. in Fertility and Sterility in 2003, which suggested that "local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization," endometrial scratching has been the subject of intense debate, and has become one of the most intriguing controversies in the field of reproductive medicine. A plethora of studies – both prospective and retrospective, as well as opinion papers, systematic reviews and meta-analyses have been published on this topic, often with conflicting results.

Our aim is to evaluate the current status of endometrial scratching in clinical practice by inviting clinicians from all over the world to share their experiences and express their personal opinions about this controversial intervention. We hope to be able to gain and instantly share with you a better understanding of the role of endometrial scratching in the management of infertility.

The data gathered from the survey will be published on the IVF-Worldwide website six weeks after the survey opens, and as always, it will stay anonymous.

Your collaboration, along with input from your peers, will enable your colleagues to learn about and understand daily clinical practice related to this important development in IVF treatment.

Prof. Adrian Shulman, President of the Israel Fertility Society, IVF Unit, Meir Medical Center, Kfar Saba, Israel
Prof. Ariel Weissman, IVF Unit Wolfson Medical Center, Israel

Are you aware of the recent publications in the NEJM, Human Reproduction and/or Fertility and Sterility about the use of endometrial scratching to facilitate implantation?
  • Yes
  • No
  • Only some of them

 

Have you ever performed or do you currently perform endometrial scratching in the management of infertility?
  • Yes
  • No

 

No

Please share with us why you did or do not perform endometrial scratching or any other endometrial injury technique to facilitate implantation for IVF/IUI.
  • I am not aware of this procedure
  • I think that the data on this procedure is confusing and not reliable
  • In my opinion, it does not make sense to do the procedure
  • Other

 

Yes

Do you currently perform endometrial scratching in the management of infertile patients?
  • Yes
  • I did in the past, but stopped doing it

 

For which of the following patient procedures have you performed endometrial scratching:
  • IUI
  • IVF
  • Both IUI and IVF

 

Prior to which types of IVF cycles do you perform endometrial scratching? (multiple answers allowed)
  • Fresh IVF cycles
  • Frozen IVF cycles
  • Egg donation cycles
  • Only for a specific indication

 

For which types of IVF/IUI patients do you recommend endometrial scratching? (multiple answers allowed)
  • General IVF/IUI population
  • Patients with repeated implantation failure
  • Patients with a thin endometrium

 

How many times prior to an IVF cycle do you perform endometrial scratching?
  • Once
  • Twice
  • Three times
  • More than three times

 

At what stage of the cycle do you perform endometrial scratching? (Multiple answers allowed)
  • During menstruation
  • During the follicular phase
  • During the midluteal phase
  • During the late luteal phase
  • Any time, does not matter

 

Do you monitor the cycle in order to time the endometrial scratching?
  • Yes
  • No
  • Only in case of irregular cycles

 

Do you send the tissue obtained from endometrial scratching for histological evaluation?
  • Yes
  • No
  • Occasionally

 

To what extent have recent publications (RCTs and meta-analyses) changed your attitude towards endometrial scratching?
  • I have read the publications, but have not changed my practice, and I perform endometrial scratching in the management of infertility
  • I have read the publications and have stopped performing endometrial scratching in the management of infertility
  • I have not read recent publications on endometrial scratching.
  • I have read the publications and have changed my practice by reducing the frequency of endometrial scratching.

 

In your opinion, which sentence best describes your attitude toward endometrial scratching?
  • Endometrial scratching increases the likelihood of implantation and live birth rates in all IVF/IUI patients
  • Endometrial scratching increases the likelihood of implantation and live birth rates in select IVF/IUI patient populations.
  • Endometrial scratching has no influence on the likelihood of implantation and live birth rates in IVF/IUI patients

 

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