Timur Gürgan1, Ziya Kalem2, Müberra N Kalem3, Halil Ruso4, Moncef Benkhalifa5, Antonis Makrigiannakis6. 1. Gürgan Clinic Women's Health and IVF Centre, Ankara, Turkey; Bahcesehir University, Faculty of Medicine, Department of Obstetrics and Gynecology Istanbul, Turkey. Electronic address: tgurgan@gurganclinic.com.tr. 2. Gürgan Clinic Women's Health and IVF Centre, Ankara, Turkey. 3. Bahcesehir University, Faculty of Medicine, Department of Obstetrics and Gynecology Istanbul, Turkey. 4. Gürgan Clinic Women's Health and IVF Centre, Ankara, Turkey; Gazi University, Faculty of Medicine, Department of Histology and Embryology, Ankara, Turkey. 5. Reproductive Medicine and Reproductive Genetics University Hospital and PERITOX Laboratory, Picardy Jules Verne University, Amiens, France. 6. University of Crete, Medical School, Department of Obstetrics and Gynecology, Heraklion, Greece.
Abstract
RESEARCH QUESTION: To investigate the effect of hysteroscopic endometrial injury for treatment of recurrent implantation failure (RIF). DESIGN: This prospective and randomized controlled trial included 239 patients who had failed to achieve a clinical pregnancy after the transfer of at least four good-quality embryos in a minimum of three fresh or frozen-thawed embryo transfer cycles and were under the age of 40 years, who were randomized into two groups. The injury group (n = 124) received endometrial injury during their hysteroscopic procedure, whereas the control group (n = 115) did not. Patients who had endometrial pathologies were excluded from the study. RESULTS: There were no statistically significant differences in duration of gonadotrophin use (8.23 versus 8.30 days), total dose of gonadotrophins (2330 versus 2338 IU), number of oocytes (7.03 versus 8.21), number of mature oocytes (5.27 versus 6.02), number of fertilized oocytes (4.19 versus 4.55), number of good-quality embryos (2.07 versus 2.43), number of embryos transferred (1.97 versus 1.93) or endometrial thickness (9.04 versus 9.35 mm) between the injury group and control group, respectively. Clinical pregnancy rates (25.8% versus 15.6%, P = 0.047), live birth rates (21.8% versus 12.2%, P = 0.049) and implantation rates (14.2% versus 8.8%, P = 0.036) were significantly different, favouring the injury group. CONCLUSION: This study suggests that endometrial injury is beneficial in RIF patients to increase the odds of implantation, clinical pregnancy and live birth.
RCT Entities:
RESEARCH QUESTION: To investigate the effect of hysteroscopic endometrial injury for treatment of recurrent implantation failure (RIF). DESIGN: This prospective and randomized controlled trial included 239 patients who had failed to achieve a clinical pregnancy after the transfer of at least four good-quality embryos in a minimum of three fresh or frozen-thawed embryo transfer cycles and were under the age of 40 years, who were randomized into two groups. The injury group (n = 124) received endometrial injury during their hysteroscopic procedure, whereas the control group (n = 115) did not. Patients who had endometrial pathologies were excluded from the study. RESULTS: There were no statistically significant differences in duration of gonadotrophin use (8.23 versus 8.30 days), total dose of gonadotrophins (2330 versus 2338 IU), number of oocytes (7.03 versus 8.21), number of mature oocytes (5.27 versus 6.02), number of fertilized oocytes (4.19 versus 4.55), number of good-quality embryos (2.07 versus 2.43), number of embryos transferred (1.97 versus 1.93) or endometrial thickness (9.04 versus 9.35 mm) between the injury group and control group, respectively. Clinical pregnancy rates (25.8% versus 15.6%, P = 0.047), live birth rates (21.8% versus 12.2%, P = 0.049) and implantation rates (14.2% versus 8.8%, P = 0.036) were significantly different, favouring the injury group. CONCLUSION: This study suggests that endometrial injury is beneficial in RIF patients to increase the odds of implantation, clinical pregnancy and live birth.
Authors: Sarah F Lensen; Sarah Armstrong; Ahmed Gibreel; Carolina O Nastri; Nick Raine-Fenning; Wellington P Martins Journal: Cochrane Database Syst Rev Date: 2021-06-10