{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T05:52:48Z","timestamp":1789969968461,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,9,2]],"date-time":"2013-09-02T00:00:00Z","timestamp":1378080000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the effect of endometrial scratching, performed during oral contraceptive pill (<jats:styled-content style=\"fixed-case\">OCP<\/jats:styled-content>) pretreatment, on reproductive outcome and on ultrasound markers of endometrial receptivity, and to assess the pain involved in the procedure, in unselected women undergoing assisted reproductive techniques (<jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Women undergoing <jats:styled-content style=\"fixed-case\">ART<\/jats:styled-content> were randomly allocated to undergo either endometrial scratching with a pipelle de Cornier or a sham procedure, 7\u201314 days before starting controlled ovarian stimulation (<jats:styled-content style=\"fixed-case\">COS<\/jats:styled-content>). We evaluated subsequent rates of clinical pregnancy, live birth, implantation, miscarriage and multiple pregnancy. Pain during the procedure was evaluated using a 10\u2010cm visual analog scale. Endometrial thickness and volume and three\u2010dimensional power Doppler (<jats:styled-content style=\"fixed-case\">3D\u2010PD<\/jats:styled-content>) indices (vascularization index (<jats:styled-content style=\"fixed-case\">VI<\/jats:styled-content>), flow index (<jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content>) and vascularization flow index (<jats:styled-content style=\"fixed-case\">VFI<\/jats:styled-content>)) were assessed during <jats:styled-content style=\"fixed-case\">COS<\/jats:styled-content> when there was at least one follicle \u2265 17 mm in diameter.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 158 women. Endometrial scratching was associated with higher rates of live birth (41.8% <jats:italic>vs<\/jats:italic> 22.8%, <jats:italic>P<\/jats:italic> = 0.01) and clinical pregnancy (49.4% <jats:italic>vs<\/jats:italic> 29.1%, <jats:italic>P<\/jats:italic> = 0.01) and higher pain score (6.42 \u00b1 2.35 cm <jats:italic>vs<\/jats:italic> 1.82 \u00b1 1.52 cm, <jats:italic>P<\/jats:italic> &lt; 0.001), endometrial <jats:styled-content style=\"fixed-case\">VI<\/jats:styled-content> (3.71 \u00b1 1.77 <jats:italic>vs<\/jats:italic> 2.95 \u00b1 1.56, <jats:italic>P<\/jats:italic> &lt; 0.01) and <jats:styled-content style=\"fixed-case\">VFI<\/jats:styled-content> (0.97 \u00b1 0.51 <jats:italic>vs<\/jats:italic> 0.76 \u00b1 0.40, <jats:italic>P<\/jats:italic> &lt; 0.01). There was no significant effect of endometrial scratching on rate of miscarriage (15.4% <jats:italic>vs<\/jats:italic> 21.7%, <jats:italic>P<\/jats:italic> = 0.53) or multiple pregnancy (22.5% <jats:italic>vs<\/jats:italic> 25.0%, <jats:italic>P<\/jats:italic> = 0.79), or on endometrial thickness (10.12 \u00b1 1.55 mm <jats:italic>vs<\/jats:italic> 9.98 \u00b1 1.62 mm, <jats:italic>P<\/jats:italic> = 0.59), endometrial volume (6.18 \u00b1 1.63 cm<jats:sup>3<\/jats:sup> <jats:italic>vs<\/jats:italic> 6.01 \u00b1 1.48 cm<jats:sup>3<\/jats:sup>, <jats:italic>P<\/jats:italic> = 0.51) or <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> (26.12 \u00b1 2.82 <jats:italic>vs<\/jats:italic> 25.91 \u00b1 2.72, <jats:italic>P<\/jats:italic> = 0.65).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Endometrial scratching performed once, during <jats:styled-content style=\"fixed-case\">OCP<\/jats:styled-content> pretreatment 7\u201314 days before starting <jats:styled-content style=\"fixed-case\">COS<\/jats:styled-content>, increases the chance of live birth and clinical pregnancy, but might cause considerable pain. Copyright \u00a9 2013 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.12539","type":"journal-article","created":{"date-parts":[[2013,6,10]],"date-time":"2013-06-10T17:40:41Z","timestamp":1370886041000},"page":"375-382","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Endometrial scratching performed in the non\u2010transfer cycle and outcome of assisted reproduction: a randomized controlled trial"],"prefix":"10.1002","volume":"42","author":[{"given":"C. O.","family":"Nastri","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto University of Sao Paulo (DGO\u2010FMRP\u2010USP) Ribeirao Preto Brazil"},{"name":"Ultrasonography and Retraining Medical School of Ribeirao Preto (EURP) Ribeirao Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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