I-26: The Role of Endometrial Injury in Improvement of The Pregnancy Rate in Patients Undergoing ART

Background: Because implantation failure is more frequent, many methods have been suggested to improve the implantation; however, their results have been inconsistent. One of the most hopeful methods is local endometrial injury. To explore the possibility that local injury of the endometrium increases the incidence of implantation and pregnancy rate in the subsequent IVF cycle in patients having previous failed IVF outcome Materials and Methods: A literature search was conducted on PubMed. The regular protocol is used; endometrial samples in patients were taken by a biopsy catheter in the follicular phase in the luteal phase or during both phases. Results: Some patients undergoing IVF treatment fail to conceive despite several attempts made with good-quality embryos and no identifiable reason. Studies have shown that inducing injury may help improve the chances of achieving pregnancy. Basic and clinical science data about the association between endometrial biopsy and improved implantation rate are limited. Nevertheless, recent evidence suggests that endometrial biopsy before IVF among women with previous repeated IVF failure is associated with improved rates of implantation, clinical pregnancies, and live births. Researchers hypothesized that the biopsy inflicted on the endometrium could lead to a massive secretion of cytokines and growth factors during the process of wound healing which could help in implantation. Conclusion: Endometrial injury may have a beneficial role in the rates of embryo implantation; improve the clinical pregnancy rate and live birth in ART. In addition, there is insufficient evidence regarding the effect of endometrial injury on miscarriage or multiple pregnancies and none on adverse events such as bleeding and pain. However, there are still several unanswered questions regarding patient selection, timing, technique and number of endometrial biopsies needed.