Objective: To examine the timing of Endometrial Scratch in a patient’, s menstrual cycle and whether there is an association with subsequent implantation. Materials and methods: This study is a retrospective chart review on women, aged 18-45, seen in a reproductive endocrine clinic seeking conception. Timing of Endometrial Scratch was defined as proliferative (cycle day 1-9), periovulatory (CD11-16), or secretory (CD19+). All periovulatory biopsies were performed at time of oocyte retrieval in women freezing all oocytes/embryos for future use. Primary outcome of interest was positive beta-hCG within ninety days of the Endometrial Scratch. Results: Sixty-nine cases of Endometrial Scratch met the inclusion criteria. There were no statistically significant differences in baseline demographic characteristics between those who received Endometrial injury in the three phases. There was no significant difference in frequency of positive beta-hCG within 90 days of Endometrial Scratch between the patients who received an Endometrial Scratch in the three phases (proliferative 65. 6%, periovulatory 69. 6%, secretory 64. 3%,p = 0. 9332). Conclusion: In contrast to prior studies which showed up to 65% decrease in implantation rate after Endometrial Scratch performed at time of oocyte retrieval, this study shows no significant difference in implantation when the injury is performed at the time of oocyte retrieval as compared to other phases of the menstrual cycle. Possible explanation may be that we did not perform a Scratch if fresh embryo transfer was planned. As Endometrial injury is associated with patient discomfort, performing the Scratch while under conscious sedation for oocyte retrieval may be desirable in cycles where fresh embryo transfer is not planned. Future studies are needed to assess the validity of these findings.

Objectives: Infertility is considered as a major issue all over the world. All the studies in this field focus on how to develop successful methods of turning infertile couples into fertile ones. Endometrial mechanical injury in order to augment the probability of implantation of embryo and pregnancy rate has been particularly noted in recent years. Considering the controversies in the use of methods and results of the previous studies, we decided to compare the pregnancy and abortion rates in the intrauterine insemination (IUI) cycles with and without intervention, by employing a new method. Materials and Methods: This interventional study was performed on 150 infertile couples who referred to the infertility treatment clinic of Al-Zahra hospital, Tabriz (from April 2016 to March 2017) and were randomly divided into two groups. The IUI procedure was carried out in the first group after the Endometrial Scratch on the first to fifth days of the menstrual cycle, while the control group underwent only IUI without any intervention. The pregnancy and abortion rates were compared in study groups. Results: Pregnancy rate in the intervention group was significantly higher compared to the control group. No relationship was observed between the abortion rate and the intervention. There was no statistically significant difference between type and cause of infertility, maternal age and body mass index (BMI), duration of infertility, number of dominant follicles and pregnancy or abortion rates. Conclusions: The Endometrial Scratching performed on the first to fifth days of the menstrual cycle, preceding IUI procedure, leads to a significant increase in pregnancy rate. On the other hand, this method can be employed with lower costs in comparison to other fertilization methods.

Background: The prevalence of infertility is increasing worldwide and the treatment is one of the important issues. Objective: This study aimed to evaluate the effect of local Endometrial Scratching on pregnancy outcomes in women with previous failure of intrauterine insemination. Materials and Methods: This non-randomized clinical trial study was performed on 336 women referred to the infertility clinic of Ali ebn-e Abitaleb Hospital of Zahedan (between May and November 2019). Women were divided into two groups: Endometrial Scratch as case and a control group. In the case group (n = 173), Endometrial Scratching was performed on days 8– 9 of the menstrual cycle in addition to routine infertility treatments, while in the control group (n = 163), only routine treatment was performed. Chi-square test was used to compare the frequency of male factor severity and the percentage of successful pregnancies between both groups and was used to investigate the effect of male factor on the fertility rate in each group (moderate male factor and mild male factor). Results: The mean age of the women was 28. 4 ± 5. 2 yr. The success rate of pregnancy in the case group was 12. 3% and in the control group 11%, which were not statistically significant (p = 0. 697). Conclusion: Overall, the results of this study showed that Endometrial Scratching had no effect on the pregnancy rate.

Background: Endometrial Scratch injury is considered controversial in increasing the success rate of assisted reproductive technology. Objective: To compare the pregnancy outcomes in women undergoing intrauterine insemination with and without an Endometrial Scratch. Materials and Methods: In this randomized clinical trial, 150 women referred to the Fatemieh Hospital, Hamadan, Iran who were candidates for IUI between December 2017 and December 2018 were randomly assigned into two groups (n = 75/each) with or without an Endometrial Scratch (as case and control groups, respectively). Women in both groups were in proper and identical protocol for IUI. Chemical and clinical pregnancies, abortion, and live birth rate, also pregnancy complications were compared between the groups. Results: Chemical and clinical pregnancy rates were higher in the case than the control group (p = 0. 25, p = 0. 54, respectively). In the case group, the abortion and multiple gestation rates were 14. 3% and 4. 3%, respectively, while it was 5% in the control group (p = 0. 60, p = 0. 54 respectively). The endometrium thickness on day 21 was higher in the case group than the control (p = 0. 01). Conclusion: Endometrial Scratching in intrauterine insemination women is not associated with an increase in both clinical and clinical pregnancy rates, however, studies with a larger sample size are recommended to evaluate this intervention.

Background: Endometrial Scratch (ES) has been suggested to improve assisted reproductive techniques success rates by investigating implantation failure. Objective: In this study, we evaluated the effect of ES on the outcomes of frozen embryo transfer (FET) in women with at least 2 failed embryo transfer cycles. Materials and Methods: In this historical cohort study, medical data of 236 infertile women who underwent in-vitro fertilization-FET at Ebne-sina Infertility Center, Tehran, Iran, from January 2015-December 2021 was extracted from their medical records. Based on having ES before FET, they were assigned to either the Scratch (n = 118) or the no-Scratch group (n = 118). We compared these groups regarding pregnancy rates and outcomes. Results: The demographic characteristics were similar in both groups regarding weight, body mass index, the number of previous embryo transfers, and the duration of infertility. However, the Scratch group had a slightly higher mean age (32.31 vs. 29.96 yr, p < 0.001). No statistically significant difference was observed between groups regarding pregnancy rate (p = 0.89). No significant association was observed between Scratch, infertility duration, the number of previous FET attempts, and the likelihood of pregnancy in a logistic regression model. No major complications were observed. Conclusion: Hysteroscopic Endometrial Scratching with scissors probably has no effect on FET outcomes, including pregnancy or live birth rates.