Endometrial Scratching by an Office Hysteroscopy for Unexplained Infertility: Predictors of Success and Pregnancy Rate

One-half of the infertile couples have unexplained infertility. The endometrial scratch (es) is believed to cause favorable endometrial inflammation, making it more receptive to an implanted embryo. We aimed to assess the success rate of es in enhancing pregnancy and to identify potential predictors for the successful outcome in couples with unexplained infertility. A case-series study included 268 couples with unexplained infertility attending the university teaching hospital in Baghdad for one year after es by an office hysteroscopy. Patients' socio-demographic factors, fertility history, and history of curettage were studied—the success of getting spontaneous pregnancy after es was studied as the dependent variable. SPSS statistical software was used, and the confidence level was employed to verify reliable predictors. The success rate following es was 44 (16.4%), confirmed by clinical pregnancy. There was a 5% decrease in the success rate of the es for every one-year increase in the female age; risk ratio (rr): 0.95; 95% ci 0.907- 0.995). The previous history of curettage increased the rate of the intervention’s success by more than two times (rr: 2.412; 95% ci: 1.181 - 4.926). Endometrial scratching improved the odds of pregnancy for couples with unexplained infertility. Potential predictors of the success were younger aged females and previous history of curettage.