Pipelle for Pregnancy in IVF (PIP-IVF)

Study design

The PIP-IVF study was a randomised controlled trial in women undergoing IVF or frozen-thawed embryo transfer with their own eggs.

The study completed recruitment in June 2017 and was published in the New England Journal of Medicine in January 2019.

A total of 1365 women were recruited to the PIP-IVF study from New Zealand, Australia, UK, Sweden and Belgium. Women were randomly allocated to either receive or not receive an endometrial scratch before their IVF cycle. 

The findings, now published in the New England Journal of Medicine, reveal no benefit from endometrial scratching: the live birth rate was exactly the same among women who did and didn’t have it (26.1 percent); nor was there any subgroup of women who appeared to benefit, including women with previous IVF failure. No difference emerged in the rates of various other outcomes, including ectopic and multiple pregnancies.

Researchers also found that the procedure caused mild pain (self-rated 3.5/10 on average) and in some cases caused adverse reactions such as excessive pain or fainting.

“It is now clear that endometrial scratching does not increase the rate of live births,” says Professor Cindy Farquhar, who is Postgraduate Professor of Obstetrics and Gynaecology at the University and medical director of Fertility Plus at Auckland District Health Board.

“On this basis of this study, which is the biggest and most robust to date, we would encourage IVF clinics to stop offering it.”

The article abstract is available at https://www.nejm.org/doi/full/10.1056/NEJMoa1808737