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Palomba S, Carone D, Vitagliano A, Costanzi F, Fracassi A, Russo T, Del Negro S, Biello A, Di Filippo A, Mangiacasale A, Monaco A, Ranieri A, Ermini B, Barba BF, Castello C, Di Guardo F, Pastorella F, Bernasconi E, Tricarico EM, Filippi F, Polsinelli F, Monte GL, Sosa Fernandez LM, Galletta M, Giardina P, Totaro P, Laganara R, Liguori R, Buccheri M, Montanino Oliva M, Piscopo R, Iuliano A, Innantuoni N, Romanello I, Sinatra F, Liprino A, Thiella R, Tiezzi A, Bartolotti T, Tomasi A, Finocchiaro V, Thiella M, Fuggetta G, Messineo S, Isabella F, Tripodi M, Iaccarino S, La Sala GB, Papaleo E, Caserta D, Marci R, Somigliana E, Guglielmino A. Fertility specialists' views, behavior, and attitudes towards the use of endometrial scratching in Italy. BMC Womens Health 2023; 23:397. [PMID: 37516869 PMCID: PMC10386779 DOI: 10.1186/s12905-023-02564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 07/22/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Endometrial scratching (ES) or injury is intentional damage to the endometrium performed to improve reproductive outcomes for infertile women desiring pregnancy. Moreover, recent systematic reviews with meta-analyses and randomized controlled trials demonstrated that ES is not effective, data on the safety are limited, and it should not be recommended in clinical practice. The aim of the current study was to assess the view and behavior towards ES among fertility specialists throughout infertility centers in Italy, and the relationship between these views and the attitudes towards the use of ES as an add-on in their commercial setting. METHODS Online survey among infertility centers, affiliated to Italian Society of Human Reproduction (SIRU), was performed using a detailed questionnaire including 45 questions with the possibility to give "closed" multi-choice answers for 41 items and "open" answers for 4 items. Online data from the websites of the infertility centers resulting in affiliation with the specialists were also recorded and analyzed. The quality of information about ES given on infertility centers websites was assessed using a scoring matrix including 10 specific questions (scored from 0 to 2 points), and the possible scores ranged from 0 to 13 points ('excellent' if the score was 9 points or more, 'moderate' if the score was between 5 and 8, and 'poor' if it was 4 points or less). RESULTS The response rate was of 60.6% (43 questionnaires / 71 infertility SIRU-affiliated centers). All included questionnaires were completed in their entirety. Most physicians (~ 70%) reported to offer ES to less than 10% of their patients. The procedure is mainly performed in the secretory phase (69.2%) using pipelle (61.5%), and usually in medical ambulatory (56.4%) before IVF cycles to improve implantation (71.8%) without drugs administration (e.g., pain drugs, antibiotics, anti-hemorrhagics, or others) before (76.8%) or after (64.1%) the procedure. Only a little proportion of infertility centers included in the analysis proposes formally the ES as an add-on procedure (9.3%), even if, when proposed, the full description of the indications, efficacy, safety, and costs is never addressed. However, the overall information quality of the websites was generally "poor" ranging from 3 to 8 and having a low total score (4.7 ± 1.6; mean ± standard deviation). CONCLUSIONS In Italy, ES is a procedure still performed among fertility specialists for improving the implantation rate in IVF patients. Moreover, they have a poor attitude in proposing ES as an add-on in the commercial setting.
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Affiliation(s)
- Stefano Palomba
- Sant'Andrea Hospital, University "Sapienza" of Rome, Rome, Italy.
| | | | | | - Flavia Costanzi
- Sant'Andrea Hospital, University "Sapienza" of Rome, Rome, Italy
| | | | - Tiziana Russo
- Grande Ospedale Metropolitano, Reggio Calabria, Italy
- Gatjc Fertility Center, Gioia Tauro, Reggio Calabria, Italy
| | - Serena Del Negro
- Gatjc Fertility Center, Gioia Tauro, Reggio Calabria, Italy
- Presidio Ospedaliero Di Soverato "Basso Ionio", Soverato, Catanzaro, Italy
| | | | | | | | | | | | - Beatrice Ermini
- Centro Italiano Di Procreazione Assistita - CIPA, Rome, Italy
| | | | - Claudio Castello
- Centro FIVET Città Di Torino, Casa Della Salute Valdese, Turin, Italy
| | - Federica Di Guardo
- Azienda Ospedaliero Universitaria Policlinico "G. Rodolico - San Marco", Catania, Italy
| | | | | | | | - Francesca Filippi
- Fondazione IRCCS Ca' Grande - Ospedale Maggiore - University of Milan, Milan, Italy
| | | | - Giuseppe Lo Monte
- Centro Di Medicina Della Riproduzione E Crioconservazione Dei Gameti, Ospedale Di Brunico, Bolzano, Italy
| | | | - Marco Galletta
- Centro Di Procreazione Medicalmente Assistita, Azienda Ospedaliera "Papardo", Messina, Italy
| | | | - Pasquale Totaro
- Centro Di Procreazione Medicalmente Assistita, Ospedale Santa Maria, Bari, Italy
| | | | | | | | | | | | - Assunta Iuliano
- UOC Di Ostetricia E Ginecologia, Azienda Ospedaliera "San Carlo", Potenza, Italy
| | | | - Irene Romanello
- SSD Di Procreazione Medicalmente Assistita, Azienza Sanitaria Friuli Occidentale, Sacile, Pordenone, Italy
| | | | | | | | | | | | | | | | | | - Giuseppa Fuggetta
- SSD Di Procreazione Medicalmente Assistita, Azienza Sanitaria Friuli Occidentale, Sacile, Pordenone, Italy
| | | | | | | | | | | | | | | | | | - Edgardo Somigliana
- Fondazione IRCCS Ca' Grande - Ospedale Maggiore - University of Milan, Milan, Italy
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Kanta Goswami S, Banerjee S, Saha P, Chakraborty P, Kabir SN, Karimzadeh MA, Mohammadian F, Mashayekhy M, Saldeen P, Kallen K, Karlstrom PO, Rodrigues-Wallberg KA, Salerno A, Nazzaro A, Di Iorio L, Marino S, Granato C, Landino G, Pastore E, Ghoshdastidar B, Chakraborty C, Ghoshdastidar BN, Ghoshdastidar S, Partsinevelos GA, Papamentzelopoulou M, Mavrogianni D, Marinopoulos S, Dinopoulou V, Theofanakis C, Anagnostou E, Loutradis D, Franz C, Nieuwland R, Montag M, Boing A, Rosner S, Germeyer A, Strowitzki T, Toth B, Mohamed M, Vlismas A, Sabatini L, Caragia A, Collins B, Leach A, Zosmer A, Al-Shawaf T, Beyhan Z, Fisch JD, Danner C, Keskintepe L, Aydin Y, Ayca P, Oge T, Hassa H, Papanikolaou E, Pados G, Grimbizis G, Bili H, Karastefanou K, Fatemi H, Kyrou D, Humaidan P, Tarlatzis B, Gungor F, Karamustafaoglu B, Iyibozkurt AC, Ozsurmeli M, Bastu E, Buyru F, Di Emidio G, Vitti M, Mancini A, Baldassarra T, D'Alessandro AM, Polsinelli F, Tatone C, Leperlier F, Lammers J, Dessolle L, Lattes S, Barriere P, Freour T, Elodie P, Assou S, Van den Abbeel E, Arce JC, Hamamah S, Assou S, Dechaud H, Haouzi D, Van den Abbeel E, Arce JC, Hamamah S, Tiplady S, Johnson S, Jones G, Ledger W, Eizadyar N, Ahmad Nia S, Seyed Mirzaie M, Azin SA, Yazdani Safa M, Onaran Y, Iltemir Duvan C, Keskin E, Ayrim A, Kafali H, Kadioglu N, Guler B, Var T, Cicek MN, Batioglu AS, Lichtblau I, Olivennes F, de Mouzon J, Dumont M, Junca AM, Cohen-Bacrie M, Hazout A, Belloc S, Cohen-Bacrie P, Allegra A, Marino A, Sammartano F, Coffaro F, Scaglione P, Gullo S, Volpes A, Cohen-Bacrie P, Cohen-Bacrie M, Hazout A, Lichtblau I, Dumont M, Junca AM, Belloc S, Prisant N, de Mouzon J, Saare M, Vaidla K, Salumets A, Peters M, Jindal UN, Thakur M, Shvell V, Diamond MP, Awonuga AO, Veljkovic M, Macanovic B, Milacic I, Borogovac D, Arsic B, Pavlovic D, Lekic D, Bojovic Jovic D, Garalejic E, Jayaprakasan K, Eljabu H, Hopkisson J, Campbell B, Raine-Fenning N, Kop P, van Wely M, Mol BW, Melker AA, Janssens PMW, Nap A, Arends B, Roovers JPWR, Ruis H, Repping S, van der Veen F, Mochtar MH, Sargin A, Yilmaz N, Gulerman C, Guven A, Polat B, Ozel M, Bardakci Y, Vidal C, Giles J, Remohi J, Pellicer A, Garrido N, Javdani M, Fallahzadeh H, Davar R, Sheibani H, Leary C, Killick S, Sturmey RG, Kim SG, Lee KH, Park IH, Sun HG, Lee JH, Kim YY, Choi EM, Van Loendersloot LL, Van Wely M, Repping S, Bossuyt PMM, Van Der Veen F, Roychoudhury Sarkar M, Roy D, Sahu R, Bhattacharya J, Eguiluz Gutierrez- Barquin I, Sanchez Sanchez V, Torres Afonso A, Alvarez Sanchez M, De Leon Socorro S, Molina Cabrillana J, Seara Fernandez S, Garcia Hernandez JA, Ozkan ZS, Simsek M, Kumbak B, Atilgan R, Sapmaz E, Agirregoikoa JA, DePablo JL, Abanto E, Gonzalez M, Anarte C, Barrenetxea G, Aleyasin A, Mahdavi A, Agha Hosseini M, Safdarian L, Fallahi P, Bahmaee F, Guler B, Kadioglu N, Sarikaya E, Cicek MN, Batioglu AS, Segawa T, Teramoto S, Tsuchiyama S, Miyauchi O, Watanabe Y, Ohkubo T, Shozu M, Ishikawa H, Yelian F, Papaioannou S, Knowles T, Aslam M, Milnes R, Takashima A, Takeshita N, Kinoshita T, Chapman MG, Kilani S, Ledger W, Dadras N, Parsanezhad ME, Zolghadri J, Younesi M, Floehr J, Dietzel E, Wessling J, Neulen J, Rosing B, Tan S, Jahnen-Dechent W, Lee KS, Joo JK, Son JB, Joo BS, Risquez F, Confino E, Llavaneras F, Marval I, D'Ommar G, Gil M, Risquez M, Lozano L, Paublini A, Piras M, Risquez A, Prochazka R, Blaha M, Nemcova L, Weghofer A, Kim A, Barad DH, Gleicher N, Kilic Y, Bastu E, Ergun B, Howard B, Weiss H, Doody K, Dietzel E, Wessling J, Floehr J, Schafer C, Ensslen S, Denecke B, Neulen J, Veitinger T, Spehr M, Tropartz T, Tolba R, Egert A, Schorle H, Jahnen-Dechent W, Bastu E, Alanya S, Yumru H, Ergun B. FEMALE (IN)FERTILITY. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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