ENDOMETRIAL SCRATCHING AS A NEW OPPORTUNITIES OF INFERTILITY SCREENING AND ENDOMETRIAL RECEPTIVITY IMPROVEMENT IN SCOPE OF NURSING PRACTICE

Abstract

It is believed that low success rate in assisted reproductive technologies is due to endometrial abnormalities. The current available methods of endometrial screening and therapy remain highly ineffective. The endometrial scratching is one of the newest and promising methods of screening and improvement of endometrial receptivity. A simple and easy to perform procedure performed in an outpatient setting, it is a painless and minimally invasive technique. The aim of this study was to assess the effect of endometrial scratching (ES) on the pregnancy rate and clinical outcome in patients with subfertility of unknown etiology and repetitive unsuccessful attempts of IUI. 74 patients who have failed to achieve pregnancy after 3 consecutive IUI’s were included in the study and suggested to continue their treatment for up to 3 additional IUI attempts. Patients were divided into two groups. Group A core group (n=37) underwent endometrial scratching, while group B (n=37) control group were not. Endometrial samples were collected on day 20 of spontaneous menstrual cycle preceding the IUIs using “Pipelle de Cornier” catheter. The following finding have been stated: in the main group the pregnancy rate has been rather high during the first 2 cycles of IUI and it has reduced only in the third cycle; in the control group the pregnancy rate has been reducing constantly during all three cycles of IUI; in the main group the pregnancy rate has been higher than in the control group during all three cycles of IUI, the “take-home baby” was higher than that in the control group for 1,75 times (37,8% to 21,6% respectively). The results of this study suggest that the local injury to the endometrium before an IUI cycle significantly improves the rates of clinical pregnancy and live birth in a specific population of subfertile women. While ES appears to be an effective tool in improving the endometrial abnormalities, more studies are needed to better define the target population of patients who may benefit from this procedure.