Site-specific endometrial injury improves implantation and pregnancy in patients with repeated implantation failures.
BACKGROUND
To test whether a site-specific hysteroscopic biopsy-induced injury in the endometrium during the controlled ovarian hyperstimulation cycle improves subsequent embryo implantation in patients with repeated implantation failure, a total of 30 patients who have had good responses to controlled ovulation stimulation but have failed to achieve pregnancy after two or more transfers of good-quality embryos were recruited in this prospective study.


METHODS
A single, site-specific hysteroscopic biopsy-induced injury was generated on the posterior endometrium at midline 10-15 mm from the fundus during the D4-D7 period of the ongoing controlled ovarian hyperstimulation cycle in six patients.


RESULTS
Patients received endometrial biopsy protocol achieved a pregnancy rate of 100%. By contrast, only 46% of patients with similar clinical characteristics (N = 24) achieved pregnancy without the hysteroscopic biopsy-induced endometrium injury (p < 0.05).


CONCLUSIONS
Our proof-of-concept study demonstrates that a site-specific hysteroscopic endometrium injury performed during the ongoing in vitro fertilization (IVF) cycle, instead of injuries received during prior cycles, significantly improves clinical outcomes in patients with repeated implantation failure.
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital Linkou Medical Center, Chang Gung University, 5 Fu-Shin Street, Kweishan, Taoyuan, Taiwan.
Shang Yu
SY
Huang
Chin-Jung
CJ
Wang
Yung-Kuei
YK
Soong
Hsin-Shih
HS
Wang
Mei Li
ML
Wang
Chieh Yu
CY
Lin
Chia Lin
CL
Chang
D000328:Adult; D010064:Embryo Implantation; D004717:Endometrium / Q000601:surgery*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D006801:Humans; D020702:Hysteroscopes; D007247:Infertility, Female / Q000601:surgery* / Q000628:therapy; D010812:Physical Stimulation / Q000379:methods; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D013525:Surgical Instruments; D013624:Taiwan