Abstract
Objective: To explore whether differential endometrial injury (EI) timing prior to a frozen-thawed embryo transfer (FET) cycle yields similar improvements in pregnancy outcomes. Materials and Methods: A total of 688 women underwent consecutive FET cycles. Based on their desire to undergo differentially timed EI or not, patients were divided into four groups: on the 3 rd-5 th day of the menstrual phase of the FET cycle (n = 308), on the 3 rd-5 th day of the menstrual phase preceding the FET cycle (n = 78), during the luteal phase of the cycle preceding the FET cycle (n = 83), and no intervention (n = 219). Results: The pregnancy outcomes in the four groups were significantly different. The chemical pregnancy, clinical pregnancy, implantation, and live birth rates of patients who underwent EI on the 3 rd-5 thday of the menstrual phase preceding the FET cycle were the highest, followed by those who underwent EI on the 3 rd-5 th day of the menstrual phase of the FET cycle. The lowest rates were those during the luteal phase of the cycle preceding the FET cycle and patients who had no interventions, which were similar. Conclusions: Differential EI timing resulted in differential improvement of pregnancy outcomes for FET.
Highlights
Embryo implantation is a rate-limiting step for a successful pregnancy in a patient undergoing in vitro fertilization and embryo transfer (IVF-ET) [1]
The results showed that endometrial injury (EI) preceding the IVF-ET cycle doubles the chances for implantation and a successful pregnancy, compared with IVF-ET without EI
Subjects in the experimental group were those who volunteered to participate in one of the three endometrial scratching groups, whereas the control group subjects were those who declined endometrial biopsy in contemporaneous frozen-thawed embryo transfer (FET) cycles. Based on their desire to undergo differentially timed EI or not, patients were divided into four groups
Summary
Embryo implantation is a rate-limiting step for a successful pregnancy in a patient undergoing in vitro fertilization and embryo transfer (IVF-ET) [1]. Since 1993, clinical studies on the relationship between EI and successful implantation have been performed in women undergoing IVF [1, 7–10] In these studies, Barash et al first demonstrated the possible role of EI in implantation improvement. A systematic review by Almog et al [11] strongly supported performing EI prior to IVF-ET cycles in patients with previous repeated IVF failures to increase implantations, clinical pregnancies, and live birth rates. They raised questions that remain unanswered about the impact of differential EI timing on IVF-ET outcomes.
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