Complement of IVF shown to be without benefit, scientists find | Society

A procedure to increase the risk of successful pregnancy in women undergoing IVF has been a stroke of research that reveals that it does not improve the chances of having a live birth .

An endometrial scratch involves grazing the uterine tissue, as occurs during a tissue biopsy, in a process that takes about a minute and is similar to a smear test – but more painful and invasive.

Several studies have previously suggested that it could offer an advantage in IVF Among them, a study conducted in 2016 showed that even though many expensive "add ons" of IVF had little evidence behind them, the endometrial scratch seemed to at least improve the rate of live births. It has been suggested that inflammation triggered by scratching could help embryos to implant.

Many private fertility centers, including those in the UK, currently offer the procedure with costs of up to £ 350, although it is not routinely offered on the NHS.

But the new research, the most comprehensive study to date, has found that the scratch does not make any difference to the chances of women undergoing IVF having a live birth.

"Many studies that have up to now, they are not of the best quality – they are all associated with different risks of bias," said Dr. Sarah Lensen of Auckland University which presents the results of the annual meeting of the European Society of Human Reproduction and Embryology in Barcelona. "We wanted to conduct a test that was really robust and recruited a lot of women so that we can answer the question [of whether it has a benefit] once and for all. "

The study involved 1364 women in 13 centers and five countries who were undergoing IVF with their own eggs. randomly to have a scratch of the endometrium, while the others do not have it.The team found that both groups had the same live birth rate, a little over 26 %, without difference in the rates of results, there co including ectopic pregnancies or multiple pregnancies.

useful for women whose embryos fail to implant, the team also specifically looked at women who were known to have two or more embryos transferred but did not become speakers.

The team also failed to find a benefit when they considered other differences, as if the IVF procedure involved fresh or frozen embryos.

However, they say that women found the scratch of the endometrium uncomfortable. In addition, five women experienced excessive pain and two had excessive bleeding.

Cindy Farquhar, postdoctoral professor of obstetrics and gynecology at the University of Auckland and lead author of the research, told The Guardian clinics to stop offering women.

"I think it's unreasonable for clinics to ask patients to pay for something while there's now clear evidence that it's not there. has no additional benefit, "she said. "I hope that it will disappear from the list of add-ons that many clinics have in the UK and New Zealand and Australia."

Stuart Lavery, a consultant gynecologist at Hammersmith Hospital who was not involved in the study, women who have recurrent implantation failures are difficult to treat . "This mini-trauma has offered a potentially exciting path and has become widely adopted in international practice and British practice," he said. "Now, someone has been brave enough to make a big random control track and shown that it has no benefit."

Lavery added that he expects the practice to change. "I do not think people will stop scratching, because it's a lawsuit that adds to the literature, but I think people could now pause and really wonder if it could be something for patients ". the procedure is painful.

Nick Macklon, medical director of the London Women's Clinic, said that in light of the new study, the scraping of the endometrium had probably been overused. But he said it's too early to cancel the proceedings, adding that work is needed to explore whether it could still benefit some women.

"There are different causes of implant failure: it could be the embryo, it could be the uterus," he said. "What we need to establish, is: in these women, there is a uterine problem, and is this problem something that could be dealt with with this?"