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ORIGINAL RESEARCH article

Front. Reprod. Health
Sec. Assisted Reproduction
Volume 6 - 2024 | doi: 10.3389/frph.2024.1505842
This article is part of the Research Topic Highlights in Assisted Reproduction 2022/23 View all articles

Endometrial scratching and Intralipid treatment – no general recommendations

Provisionally accepted
Mrosk Paolina Mrosk Paolina 1Sandi-Monroy Nathallie Sandi-Monroy Nathallie 2Gagsteiger Friedrich Gagsteiger Friedrich 3Friedl Wolfram Paul Thomas Friedl Wolfram Paul Thomas 1Katharina Hancke Katharina Hancke 1Karin Bundschu Karin Bundschu 1*
  • 1 Ulm University Medical Center, Ulm, Germany
  • 2 Sartorius Stedim Cellca GmbH, Ulm, Germany
  • 3 Bestfertility, Ulm, Germany

The final, formatted version of the article will be published soon.

    Objectives: Endometrial scratching (ES) and/or intravenous intralipid therapy (in cases of increased uterine natural killer cells, uNKs) are still conducted in several fertility centers as "add-on" treatments in patients undergoing ART, although convincing evidence for beneficial effects is lacking.In this retrospective study, associations between ES treatment or additional intralipid therapy and pregnancy and live birth rates of 1546 patients undergoing 2821 IVF-/ICSI-treatment cycles with fresh or frozen embryo transfers in a German fertility-center between 1st January 2014 and 31th May 2017 were analyzed.Results: Overall pregnancy and live birth rates for all 2821 treatment cycles (468 cycles with ES) were 32.8% and 23.5%. There were no statistically significant differences in pregnancy or live birth rates between first treatment cycles with and without ES (p=0.915 and p=0.577) or between second cycles following an unsuccessful first cycle with and without ES (p=0.752 and p=0.623). These results were confirmed using multivariable generalized estimating equations (GEE) models accounting for non-independency of multiple treatment cycles per patients that included all cycles and showed no significant effect of ES on pregnancy (p=0.449) or live birth rates (p=0.976). Likewise, a GEE model revealed no significant effect of intralipid treatment on pregnancy (p=0.926) and live birth rates (p=0.727).Our results reveal no evidence that ES increases the pregnancy or live birth rates in women undergoing their first or further IVF cycle with fresh or frozen embryo transfer. Intralipid treatment was also not beneficial. Even if patients explicitly ask for it, these procedures are not recommended outside of clinical studies.

    Keywords: Endometrial scratching, Endometrial injury, Intralipid, Uterine natural killer cells, Repeated implantation failure

    Received: 03 Oct 2024; Accepted: 13 Nov 2024.

    Copyright: © 2024 Paolina, Nathallie, Friedrich, Thomas, Hancke and Bundschu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Karin Bundschu, Ulm University Medical Center, Ulm, Germany

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