The Addition of Endometrial Injury to Freeze-All Strategy in Women with Repeated Implantation Failures

Abstract

(1) Background: Recurrent implantation failure (RIF) after IVF remains a challenging topic for fertility specialists and a frustrating reality for patients with infertility. Various approaches have been investigated and applied towards the improvement of clinical outcomes. Through a nonrandomized clinical trial, we evaluated the effect of the combination of hysteroscopic endometrial injury and the freeze-all technique on pregnancy parameters in a cohort of RIF patients; (2) Methods: The study group comprised of 30 patients with RIF that underwent a hysteroscopic endometrial injury prior to a frozen embryo transfer cycle; another 30 patients with RIF, comprising the control group, underwent a standard frozen cycle with no adjuvant treatment before. Live birth comprised the primary outcome. Logistic and Poisson regression analyses were implemented to reveal potential independent predictors for all outcomes. (3) Results: Live birth rates were similar between groups (8/30 vs. 3/30, p = 0.0876). Biochemical and clinical pregnancy and miscarriages were also independent of the procedure (p = 0.7812, p = 0.3436 and p = 0.1213, respectively). The only confounding factor that contributed to biochemical pregnancy was the number of retrieved oocytes (0.1618 ± 0.0819, p = 0.0481); (4) Conclusions: The addition of endometrial injury to the freeze-all strategy in infertile women with RIF does not significantly improve pregnancy rates, including live birth. A properly conducted RCT with adequate sample size could give a robust answer.

Is Hysteroscopy Prior to IVF Associated with an Increased Probability of Live Births in Patients with Normal Transvaginal Scan Findings after Their First Failed IVF Trial?

“…The aim of this study was to evaluate whether hysteroscopy in the cycle prior to a second attempt of IVF/ICSI can lead to a higher probability of pregnancy compared to having no hysteroscopy, in women with a failed first attempt and normal findings at TVS. While other studies have chosen to study women with recurrent implantation failure (RIF)-study Siri [ 9 ], this study focuses on women who have failed to achieve pregnancy after a first unsuccessful IVF/ICSI attempt in order to potentially increase the efficiency of Assisted Reproductive Technology (ART) earlier in the course of treatment, especially when considering how stressful and financially demanding IVF/ICS can be.…”

Effectiveness of endometrial scratching in infertility treatment with assisted reproductive technologies

“…Некоторые исследователи ставят диагноз ПНИ уже после 2 предшествующих неудач имплантации [15][16][17]. Другие авторы полагают, что следует также уделять внимание количеству и качеству перенесенных эмбрионов, и рассматривают ПНИ как неспособность достичь клинической беременности после 3 последовательных попыток ЭКО, при которых в каждом цикле переносится от 1 до 2 эмбрионов высокого качества [18,19]. C. Coughlan et al (2014) предложили более строгие диагностические критерии и определили ПНИ как отсутствие эффекта после переноса по меньшей мере 4 свежих или размороженных эмбрионов хорошего качества в течение минимум 3 циклов в возрасте до 40 лет [12].…”

Immune Cell Functionality during Decidualization and Potential Clinical Application

“…However, the studies came to inconsistent conclusions. Several studies show an enhanced implantation rate after scratching [ 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 ], while there are also several studies that could not or barely show significant differences due to scratching [ 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 ...…”