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Several small trials have suggested that using a plastic biopsy catheter to scratch the endometrium prior to in vitro fertilization (IVF) might increase the likelihood of implantation and raise live birth rates; accordingly, many clinicians have adopted this procedure despite unproven efficacy and higher cost. These considerations led investigators to enroll >1300 women undergoing IVF in an open-label trial at centers in five countries to assess the procedure's efficacy. Participants were randomly assigned to endometrial scratching (between day 3 of the cycle preceding and day 3 of the embryo-transfer cycle) or no intervention.
Live births occurred in 180 of 690 women (26%) in the endometrial-scratch group and 176 of 674 women (26%) in the c…