Comparison of Clinical Pregnancy Rates and Implantation Rates in Hysteroscopic Lateral Metroplasty versus Endometrial Scratching in Patients of Repeated Implantation Failures
Authors: Kale Ashwini , Kale Ashish 
Published: April 2021

ABSTRACT
Introduction
Implantation is one of the rate-limiting steps of success rates in patients undergoing in vitro fertilization. Repeated implantation failure is defined as failure of good-quality embryos to successfully implant in uterine cavity in repeated IVF treatment cycle. The cause of such implantation failures may be maternal or embryonal. Endometrial scratching and lateral metroplasty are found to increase successful implantation rates in various studies. There is hardly any study in the literature comparing the success rates of endometrial scratching and hysteroscopic lateral metroplasty. Keeping in mind this fact, we conducted this comparative study to compare the successful pregnancy rates and clinical pregnancy rates in patients who had undergone endometrial scratching and hysteroscopic lateral metroplasty for repeated implantation failures.

Materials and methods
A total of 60 patients having primary or secondary infertility and had history of repeated implantation failure were included in this study on the basis of a predefined inclusion and exclusion criteria. The patients were divided into two groups on the basis of treatment they received. In group A, 30 patients underwent endometrial scratching, and in group B, 30 patients underwent hysteroscopic lateral metroplasty. The successful pregnancy rates and clinical pregnancy rates in both the groups were compared. SPSS 22.0 was used for statistical analysis, and P value less than 0.05 was taken as statistically significant.

Results
Out of 60 patients, 50 (87.5%) patients belonged to primary infertility, whereas 10 (12.5%) patients were found to have secondary infertility. The mean age of patients in group A was 34.12 ± 3.12, whereas the mean age in group B was 35.42 ± 4.46 years. The mean duration of infertility in patients of group A and group B was found to be 7.43 ± 2.50 and 6.93 ± 2.54 years, respectively. The mean number of antral follicle count in group A was 9.52 ± 1.82, whereas in group B, it was 10.42 ± 1.52. In group A, 12 (40%) patients were confirmed to be having successful pregnancy on the basis of β-hCG levels on D14, whereas 17 (56.67%) patients in group B were found to have successful pregnancy on the basis of β-hCG. Fetal cardiac activity was present in 13 (43.33%) patients and 18 (60%) patients in group A and group B, respectively (p = 0.301). The difference was not found to be statistically significant (p = 0.30).

Conclusion
Endometrial scratching and hysteroscopic lateral metroplasty both are effective management strategies in patients having history of repeated implantation failure. Though lateral metroplasty appears to be a better choice, the difference was statistically insignificant (p > 0.05).
How to cite this article
Kale A, Kale A. Comparison of Clinical Pregnancy Rates and Implantation Rates in Hysteroscopic Lateral Metroplasty versus Endometrial Scratching in Patients of Repeated Implantation Failures. J South Asian Feder Obst Gynae 2020;12(6):348–352.