The Effect of Local Injury to the Endometrium for Implantation and Pregnancy Rates in ICSI –ET Cycles with Implantation Failure: a randomised controlled study

To assess the effect of local injury to the endometrium for implantation, pregnancy and live birth rates in ICSI –ET cycles with recurrent implantation failure. The study was prospectively designed and performed in a university hospital. A group of 100 women, who failed to conceive during one or more cycles of IVF and embryo transfer (ET), was treated with a long protocol for controlled ovarian hyperstimulation. The IVF treatment and ET were preceded by repeated endometrial biopsies, in a randomly selected 50 of a total of 100 women. Age of the women, days of stimulation, total dose of gonadotropins, E2 concentrations and endometrial thickness on hCG day, total MII stage oocytes, the total number of high quality embryos for transfer, the day of transfer and the number of embryos transferred were similar for both groups. Transfer of a similar number of embryos (138 and 141 in the experimental and control patients, respectively) resulted in rates of implantation (34.67 % vs. 30.88 %; p= 0,1384) clinical pregnancy (60 % vs. 34 %; p= 0.009), and live births per ET (44 % vs. 24 %; p= 0.03), which were higher in the experimental group as compared to controls. These results suggest that IVF treatment that is preceded by local injury to the endometrium improved the rates of embryo implantation, clinical pregnancy, and live births in asiste reproductive technique.