• David A Crosby, Louise E Glover, Paul Downey, Eoghan E Mooney, Fionnuala M McAuliffe, Cliona O'Farrelly, Donal J Brennan, and Mary Wingfield.
• Merrion Fertility Clinic, 60 Mount Street, Dublin 2, Ireland. crosbyd@tcd.ie.
• Ir J Med Sci. 2021 Aug 1; 190 (3): 1071-1077.

IntroductionEndometrial injury or 'scratch' preceding an assisted reproductive therapy (ART) cycle has recently been shown not to improve livebirth rates among women undergoing ART. The objective of this study was to compare pregnancy outcomes in nulliparous women who underwent an accurately timed mid-luteal scratch biopsy prior to ART with those who did not.MethodsThis was a prospective cohort study. Women were recruited between October 2016 and February 2018 inclusive. Women who met the inclusion criteria and who did not undergo an endometrial scratch in the study period were used as a comparison group. Patients underwent a cycle of ART in the menstrual cycle following endometrial scratch.ResultsNinety-eight women were eligible for participation in the study. There were no differences in rates of implantation (35.7% (n = 20/56) vs. 35.4% (n = 17/48); p = 1.00), clinical pregnancy (40.0% (n = 20/50) vs. 39.5% (n = 17/43); p = 1.00) or live birth (34.0% (n = 17/50) vs. 25.6% (n = 11/43); p = 0.50) per embryo transfer between those who underwent a scratch and those who did not.ConclusionEndometrial scratch is a simple, inexpensive and low-risk procedure. However, in this relatively small cohort study, no differences in rates of implantation, clinical pregnancy or live birth in women with primary infertility were determined between those who underwent a scratch and those who did not.© 2020. Royal Academy of Medicine in Ireland.

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