Endometrial Pipelle Scratching May Decrease Abortion Rates Rather Than Increasing Pregnancy Rates in Intrauterine Insemination Cycles

Abstract

To assess the efficacy of endometrial pipelle scratching (EPS) preceding intrauterine insemination (IUI) cycles. A total of 348 patients with unexplained infertility were enrolled into the study. 117 women with EPS were compared with 231 women without EPS and IUI. Livebirth and pregnancy rates and abortion rates were the primary outcomes. There were no difference in age, duration of infertility, basal hormone and total gonadotropin dose used throughout the cycle and endometrial thickness. In terms of pregnancy outcomes, pregnancy and livebirth rates in EPS group were17.1% and 15.7% respectively, while pregnancy and livebirth rates in Non EPS group were 23.8% and 16% respectively. Spontaneous abortion rate in EPS group was significantly lower than Non EPS group (1.7% vs. 7.8%) which was statistically significant (p = 0.021). EPS did not improve pregnancy and livebirth rates. However, abortion rates were significantly lower in EPS patients. EPS may not have any impact on the embryonic implantation but may improve the proper development of implanted embryos by modulating the local factors. © 2018 OMU