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. 2021 Mar 18;2021(3):CD011424. doi: 10.1002/14651858.CD011424.pub3
Study Reason for exclusion
Castellacci 2012 Not a randomised controlled trial
Dadras 2012 This trial is available as an abstract only and appears to be associated with extensive bias as detailed below; therefore we excluded it
  • Pregnancy rates in both groups were much higher than expected (34% vs 66%) for 3 cycles of attempted conception. A pregnancy rate of 66% is implausible given the supposed infertile nature of participants and is higher than reported in most in vitro fertilisation trials

  • One set of pregnancy data is available, and it is unclear whether this refers to ongoing or clinical pregnancy, or how these outcomes are defined

  • Another study included in this review is described as distinct from Dadras 2012 (Parsanezhad 2013). However, it is unclear how this can be the case, as both were conducted at the same centre, in overlapping time periods, and were published by overlapping study authors

  • Study authors provided information about the trial that was contradictory to information in the abstract (e.g. no mention of a sham procedure in the abstract, study authors replied to an email stating, "a mock procedure was used")

  • Participants are described as randomly allocated to groups with no further information on how this was achieved, and therefore, whether this was truly random allocation


We contacted the study authors, but they did not satisfactorily address the above issues
IRCT20180731040659N1 Study recorded biochemical pregnancy as the primary outcome, which is not a review outcome. No other secondary outcomes were listed under 'Secondary outcomes'. Study author correspondence was undertaken to check whether other pregnancy outcomes were recorded; however we did not receive a response
Kara 2016 Unintentional endometrial injury was performed. The aim of the study was to measure HOXA‐10, ‐11, and ‐LIF endometrial gene expression in women with polycystic ovary syndrome (PCOS)
NCT00064935 Unintentional endometrial injury was performed. Endometrial biopsy was performed for diagnostic purposes
NCT00737984 Trial was discontinued after only 9 participants were recruited (described on trial registration page)
NCT01111799 Author correspondence: the trial was discontinued after only 15 participants were recruited
NCT01132144 Study enrolled women undergoing assisted reproductive technology (ART) with fresh embryo transfer, which is not the study population of this review
NCT02084914 Study reported biochemical pregnancy rate only and did not report or record any of the review outcomes. Trial authors confirmed this by correspondence
New 2017 Unintentional endometrial injury was performed
Quote: "this study investigates the difference in patients’ pain perception when office hysteroscopy (OH) is performed alone compared with OH and concurrent endometrial biopsy"
Salama 2018 Quasi‐randomised trial. Allocation was based on "each alternate week referral to the clinic"
Seyam 2015 Intervention is microhysteroscopy ‐ not intentional injury
Shokeir 2016 Quasi‐randomised trial. Allocation was based on odd or even patient identification number

ART: assisted reproductive technology; OH: office hysteroscopy; PCOS: polycystic ovary syndrome.