Date of Award

1-1-2022

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

OBJECTIVE: The objective of this selective EBM review is to determine whether or not “Endometrial Scratching Increases Live Birth Rates for Women Undergoing IVF?”

STUDY DESIGN: A systematic review of three randomized control trials (RCTs) published between 2010 and 2017.

DATA SOURCES: All three RCTs were discovered using PubMed. Studies were published in English in peer-reviewed journals and selected based on applicability to the clinical question.

OUTCOMES MEASURED: In all three articles, the main outcome that will be reviewed is live birth rate. This was measured by the number of live births per embryos transferred divided by the total number of participants in each corresponding group. Outcomes were described as a percentage.

RESULTS: In the RCT conducted by Olesen et al., there was found to be a risk ratio (RR) of 1.29 (95% CI, 0.89-1.86; p = 0.176) and NNT of fifteen which is in favor of a small treatment effect for increasing live birth rate with ES in women receiving IVF. Data from RCT by Lensen et al., uncovered an odds ratio of 1.00 (95% CI, 0.78-1.27; p = 0.97) indicating there is no higher or lower risk odds of an increase in live birth rate with or without ES. Lastly, Rodriguez et al. revealed a RR of 1.128 (95% CI, 0.92-1.39), NNT of seventeen, and p = 0.286 supporting that the studies’ statistics are not significant.

CONCLUSION: The studies did not find statistical significance in ES increasing live birth rates for women receiving IVF. The treatment effect in each intervention group was small comparedto the control group. The results of this review are conclusive and show that ES does not increase live birth rate for women receiving IVF. Additional research and studies should be completed using standardized ES procedures and quality embryos.

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