Fecundability in couples with idiopathic primary infertility after endometrial scratching: a retrospective cohort study

ABSTRACT
Objective. This study aimed to investigate the effect of endometrial injury on spontaneous pregnancy rate (fecundability) in patients with long-term idiopathic primary infertility.
Materials and Methods. 153 women with primary infertility for two or more years were checked. Those in whom a cause could be identified or women with a BMI of > 30 were excluded from the study. Ninety-three women with idiopathic primary infertility who underwent office hysteroscopy in the last 6 months were included in the study provided they received counseling about office hysteroscopy with endometrial scratching and underwent the procedure. Five women were found to have ostial polyps <7 mm in size and had these polyps removed by scissors; three cases were found to have mild to moderate Asherman’s syndrome and that treated immediately by adhesiolysis using a cold knife, all excluded from the study and the remaining 85 women that had a normal, healthy endometrial cavities and scratching done were included in our study.
Results. Endometrial injury resulted in 39 (45.88 %) spontaneous pregnancies in the first 6 months after the endometrial injury, which were confirmed by transvaginal ultrasound visualization of the fetal heart at 7 weeks of gestation. Six of the 39 pregnancies resulted in an early miscarriage.
Conclusions. The results of this study showed that endometrial injury by office hysteroscopy may have a positive effect on the spontaneous pregnancy rate (fecundability) in long-term idiopathic primary infertility.