Results from the clinical trial, undertaken by a team of Brazilian scientists in collaboration with Dr Nick Raine-Fenning of the Nottingham University Research and Treatment Unit (NURTURE), demonstrate a significant benefit to the timing of endometrial scratching, reporting an increase in the clinical pregnancy rate of women undergoing IVF and ICSI treatment to 49 per cent, compared with the current average (29 per cent).
The study, being presented at the ISUOG World Congress in Sydney was also found to increase the number of live births from the current average of 23 per cent to a reported 42 per cent.
Endometrial scratching, or injury, is defined as medically administered damage to the inner lining of the womb and was first demonstrated as a beneficial procedure in reproductive medicine in 2003.
However ‘scratching’ is an intrusive procedure and many people are still unsure as to how it works or indeed if it definitely does work. Furthermore, optimal timings and protocol for this intervention are yet to be clearly defined.
Up to 15 per cent of women of reproductive age have problems conceiving and reproductive treatment failure is a cause of psychological distress for many couples.
Current attempts to improve reproductive treatments carry significant risks or are not financially viable. This clinical trial strived to determine the optimal timing of this promising intervention, simplifying protocols and minimising the impact to the patient.
158 women were recruited onto the trial, all of whom had previously received unsuccessful courses of reproductive treatment and, critically, were taking an oral contraceptive pill directly before the trial treatment commenced.
77 of these women were randomised to and received the ‘scratching’ intervention, which was administered 7-14 days before core reproductive treatment began, as part of standard pre-treatment gynaecological screening.
39 of the 77 women achieved clinical pregnancy and 33 cases resulted in live births, compared with 23 live births in the control group.
The results of the clinical trial, which were published early online in the leading journal Ultrasound in Obstetrics & Gynecology in September also demonstrated that endometrial scratching had no effect on miscarriage or multiple pregnancy rates compared with standard protocols.
Despite the wide spread use of the technique, the mechanism behind the success of endometrial scratching remains unknown. A plenary talk on the opening day (Sunday October 6) of the ISUOG World Congress in Sydney will address this question.
The study, Endometrial scratching performed in the non-transfer cycle and outcome of assisted reproduction: a randomized controlled trial, was conducted by Dr Raine-Fenning in collaboration with colleagues at the University of Sao Paolo and the Ultrasonography and Retraining Medical School of Ribeiro Preto in Brazil.
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Notes to editors: The University of Nottinghamhas 42,000 students at award-winning campuses in the United Kingdom, China and Malaysia. It was ‘one of the first to embrace a truly international approach to higher education’, according to the Sunday Times University Guide 2013. It is also one of the most popular universities among graduate employers, one of the world’s greenest universities, and winner of the Times Higher Education Award for ‘Outstanding Contribution to Sustainable Development’. It is ranked in the UK’s Top 10 and the World’s Top 75 universities by the Shanghai Jiao Tong and the QS World Rankings.
More than 90 per cent of research at The University of Nottingham is of international quality, according to the most recent Research Assessment Exercise. The University aims to be recognised around the world for its signature contributions, especially in global food security, energy & sustainability, and health. The University won a Queen’s Anniversary Prize for Higher and Further Education for its research into global food security.
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