Endometrial Scratching in Women with Recurrent First Trimester Pregnancy Loss: A Randomized Controlled Trial

Objective: to assess the role of endometrial scratching prior to ovulation induction to improve live birth rate in recurrent first trimester pregnancy loss. Methods: This randomized controlled trial included 126 patients with recurrent first trimester spontaneous miscarriage with no obvious cause who were assigned into two groups; the study group (n=62) who underwent endometrial scratching once with a pipelle de Cornier and the control group (n=64) who underwent placebo procedure, followed by ovulation induction. Live birth rate was the primary outcome in this study. Data was collected and tabulated. Results: There was a significant difference between the two groups regarding the miscarriage rate which was higher in the control group (p<0.05) and live pregnancy rate which was higher in the study group (p<0.05). There was no significant difference between the two groups regarding clinical pregnancy rate, multiple pregnancy rate, preterm delivery, admission to NICU and neonatal death (p>0.05). Conclusion: Endometrial scratching may improve live birth rates in couples with unexplained recurrent first trimester spontaneous miscarriage. Larger multicenter studies are warranted to confirm or refute these findings.