Clinical background affecting pregnancy outcome following local endometrial injury in infertile patients with repeated implantation failure

Abstract

Local endometrial injury (LEI) has been performed as a promising medical intervention to improve the pregnancy outcome in infertile women suffering from repeated implantation failure (RIF) in in vitro fertilization-embryo transfer cycles. The effect of LEI, however, remains controversial. The aim of this retrospective study was to identify the subgroups of patients with RIF who benefit from LEI. We compared the clinical parameters between the patients who had had a clinical pregnancy in the subsequent embryo transfer cycle following the LEI cycle (LEI-CP group, n = 94) and those who had resulted in negative pregnancy test (LEI-NP group, n = 114). The female age, basal follicle stimulating hormone concentration, number of past oocyte pickup cycles, and embryos/blastocysts transferred in the past three RIF cycles were significantly (p < 0.047) lower in the LEI-CP group than the LEI-NP group. The prevalence of polycystic ovarian syndrome was significantly (p = 0.0059) higher in the LEI-CP group than in the LEI-NP group. These findings suggest that LEI is most effective to improve the pregnancy outcome in patients undergoing RIF with uncompromised ovarian reserve, particularly in those with polycystic ovarian syndrome.

Effect of local endometrial injury in proliferative vs. luteal phase on IVF outcomes in unselected subfertile women undergoing in vitro fertilization

“…Likewise, Zhou et al reported that endometrial biopsy by a catheter performed under the guidance of B-ultrasound in proliferative phase of the IVF cycle improved implantation, clinical pregnancy and live birth rates in patients with irregular echoes diagnosed by ultrasound before IVF [ 10 ]. Moreover, a meta-analysis showed that endometrial injury (biopsy/scratch or hysteroscopy) performed in proliferative and/or luteal phase was 70% more likely to result in clinical pregnancy compared with no intervention, especially in unexplained RIF patients [ 11 ].It was reported that endometrial injury using a single-time curette biopsy in the proliferative phase of the preceding menstrual cycle improved the pregnancy outcome of RIF patients with uncompromised ovarian reserve [ 20 ].Recently it was suggested that hysteroscopy with local injury (with grasping forceps or scissors) to the luteal phase endometrium prior to ovarian stimulation for IVF/ICSI can improve implantation and pregnancy rates in RIF patients [ 21 ].…”

The Effects of Administrated Sildenafil Citrate on Uterine Luminal Epithelium Height Associated with Ovarian Angiogenesis: An Experimental Animal Study

“…[ 1 2 ] Implantation failure is one of the well-known causes of female infertility, and endometrial thickness (ET) is one of the strongest predictors of successful implantation. [ 3 ] A series of scientific reports have presented that embryo implantation and pregnancy rates are significantly higher in women with an ET more than 9 mm. Thin endometrium, generally measuring <7 mm, is assumed to be less able to support of implantation.…”

Endometrial microstimulation effects on endometrial receptivity assessed by transvaginal color Doppler sonography

“…Mechanical endometrium stimulation is currently attracting significant interest [9,10]. In this study, circular EM (scratching) was performed using an endometrial cell sampler.…”