Does Endometrial Mechanical Stimulation (scratch Test) Improve Pregnancy Rates in in Vitro Fertilization Cycles? A Double Blind Randomized Controlled Trial

Previous studies on the benefit of mechanical endometrial stimulation prior to embryo transfer on clinical pregnancy and live birth rates are conflicting. Given this, we designed a double-blind randomized controlled trial to determine if endometrial mechanical stimulation in the form of an endometrial biopsy performed in the luteal phase of the cycle prior to embryo transfer increases the odds of clinical pregnancy. Double-Blind Randomized Controlled Trial Prior to the start of the study, the protocol and consent forms were approved by Washington University in St Louis’s IRB. Women undergoing embryo transfer (fresh or frozen) between 2013 and 2017 at Washington University in St Louis, with a normal uterine cavity were included. Exclusion criteria were: third party reproduction cycles and women undergoing poor responder stimulation protocols. Patients were enrolled at the time of intervention (endometrial biopsy or sham endometrial biopsy) in this prospective, randomized, double-blinded study. Statistical analyses were performed using chi-square analysis in SPSS. Baseline characteristics between patients enrolled in the two study arms were not different. No significant difference in clinical pregnancy rate was seen between women who received the intervention (endometrial biopsy) and those who did not (67% vs. 75%, p=0.46; OR 0.69, CI: 0.26-1.83). Endometrial mechanical stimulation in the luteal phase prior to embryo transfer does not improve the odds of clinical pregnancy.