Successful pregnancy and delivery of a healthy baby after endometrial biopsy treatment in an in vitro fertilization patient with severe Asherman syndrome.

OBJECTIVE To implement the procedure of endometrial biopsy in a case of severe Asherman syndrome as a possible treatment to increase uterine receptivity. DESIGN Case report. SETTING IVF Unit, Kaplan Medical Center, Rehovot, Israel. PATIENT(S) A 29-year-old patient with severe Asherman syndrome, who underwent six operative hysteroscopies combined with hormonal treatment, and no functional receptive endometrium was achieved. INTERVENTION(S) We performed three endometrial biopsies on days 8, 12, and 21 of a progyluton-induced menstrual cycle, and a fourth biopsy on day 21 of the next induced menstrual cycle. After that cycle the patient underwent an IVF treatment. MAIN OUTCOME MEASURE(S) Ultrasound measurement of endometrial thickness, serum beta-hCG, sonography test for the presence of a gestational sac with heartbeat, and pregnancy follow-up until birth. RESULT(S) Biopsy treatment increased the thickness of the endometrium from unobservable by sonography to 7 mm on the day of hCG administration. The next IVF cycle resulted in implantation of an embryo and the birth of a healthy baby boy. CONCLUSION(S) Repeated endometrial biopsies may be used in patients with Asherman syndrome immediately after forming a uterine cavity by hysteroscopy to improve its receptivity.