1. To familiarize the audience with the importance of inadequate uterine remodeling as a potential cause of unexplained infertility and implantation defects.
2. To familiarize the audience with the importance of the cellular immune system in the creation of spiral arterioles to allow nutrient exchange between mother and fetus.
3. To familiarize the audience in some methods used by the fetal-placental unit to counteract this increased cellular immune response from immune attack of the fetal semi-allograft.
4. To familiarize the audience with the possible role of endometrial irritation (scratch) in improving potential inadequate uterine re-modeling related to an inadequate cellular immune response.
5. To make the audience aware that the endometrial scratch can be a double-edged sword in that in some circumstances it can produce an excessive cellular immune response thus inhibiting successful implantation.
6. The objective is to present some data suggesting when to employ the endometrial scratch and when not to use it.
7. The objective is to learn when in the menstrual cycle is the best time to perform the procedure.
8. The objective is to suggest how long the effectiveness of the endometrial scratch is.
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- Hameed A, Malik S, Regan L: Debate: Should progesterone supplements be used? No. Ed. Howard J.A. Carp. In: Recurrent Pregnancy Loss – Causes, Controversies, and Treatment, Second Edition, Chapter 15, pgs 131-135, CRC Press 2014
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- Check JH. Pros and cons of the use of progesterone to reduce miscarriage rates. Clin Exp Obst Gyn 2018;45:652-655
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- Choe JK, Check JH, Nowroozi K, Benveniste R, Barnea ER. Serum progesterone and 17‑hydroxyprogesterone in the diagnosis of ectopic pregnancies and the value of progesterone replacement in intrauterine pregnancies when serum progesterone levels are low. Gynecologic and Obstetric Investigation. 34:133‑138, 1992
- Check JH, Winkel CA, Check ML: Abortion rate in progesterone treated women presenting initially with low first trimester serum progesterone levels. The Am J Gyn Health IV(2):63/33‑34/64, March‑April, 1990.
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- Check JH, Liss JR, Vaniver J. The effect of clomiphene citrate vs. letrozole on post-coital tests. Clin Exp Obst Gynecol 2016;43:184-185.
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- Check JH, Aly J, Chang E. Improving the chance of successful implantation – part I – embryo attachment to the endometrium and adequate trophoblast invasion. Clin Exp Obst Gynecol 2016;43787-791.
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- Chang E t al. An endometrial scratch can improve pregnancy rates in unexplained infertility given luteal phase progesterone support. Clin Exp Obst Gyn, in press.
- Check JH, Choe JK, Cohen R, Summers-Chase D. Effect of taking a one time injection of one mg leuprolide acetate three days after embryo transfer on pregnancy outcome and level of first beta human chorionic gonadotropin (beta-hCG) level. Clin Exp Obstet Gynecol. 2015;42(5):568-570.
- Gibreel A, Badawy A, El-Refai W, El-Adawi N. Endometrial scratching to improve pregnancy rate in couples with unexplained subfertility: a randomized controlled trial. J Obstet Gynaecol Res. 2013;39(3):680-684. doi:10.1111/j.1447-0756.2012.02016.x
- Vitagliano A, Noventa M, Saccone G, et al. Endometrial scratch injury before intrauterine insemination: is it time to re-evaluate its value? Evidence from a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2018;109(1):84-96.e4. doi:10.1016/j.fertnstert.2017.09.021
- Lensen S, Osavlyuk D, Armstrong S, et al. A Randomized Trial of Endometrial Scratching before In Vitro Fertilization. N Engl J Med. 2019;380(4):325-334. doi:10.1056/NEJMoa1808737
- Vitagliano A, Di Spiezio Sardo A, Saccone G, et al. Endometrial scratch injury for women with one or more previous failed embryo transfers: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 2018;110(4):687-702.e2. doi:10.1016/j.fertnstert.2018.04.040
- Check JH, Check ML. A case report demonstrating that follicle maturing drugs may create an adverse uterine environment even when not used for controlled ovarian hyperstimulation. Clin Exp Obst Gyn 28:217-218, 2001.