Abstract
AimTo explore the clinical effect of endometrial injury (EI) on the third day of the menstrual cycle before frozen–thawed embryo transfer (frozen–thawed ET) on patients experienced two or more implantation failures.MethodsA total of 200 patients who suffered at least two failed hormone‐replacement therapies and frozen–thawed ET were randomly divided into two groups: EI group and control group (n = 100 in each group). Patients in the EI group received local EI with a Pipelle catheter on the third day of the menstrual cycle before frozen–thawed ET. Primary outcomes were live birth, clinical pregnancy and implantation rates. Secondary outcomes were biochemical, multiple and ectopic pregnancy rates and abortion rates.ResultsThe rate of live birth in EI group (51.00%) was significantly higher than that of control group (36.00%) (P = 0.032). Clinical pregnancy and implantation rates in EI group were significantly higher comparing to control group (64.00% vs 48.00%, P = 0.023 and 46.74% vs 30.11%, P = 0.001). The rate of multiple pregnancy in EI group (37.50%) was significantly higher than that of control group (18.75%) (P = 0.031). No significant difference in ectopic pregnancy rate and abortion rate was observed between EI group and control group.ConclusionApplying EI to patients experienced two or more implantation failures on the third day of the menstrual cycle before frozen–thawed ET can improve clinical outcomes.
Highlights
Successful implantation depends on both embryo quality and endometrial environment.[1]
A total of 200 participants who received frozen–thawed ET after two or more implantation failures were divided into two groups: endometrial injury (EI) group (n = 100) and control group (n = 100)
Our study indicated that performing EI on the third day of the menstrual cycle on patients with two or more times implantation failures before frozen– thawed ET could improve clinical outcomes
Summary
Successful implantation depends on both embryo quality and endometrial environment.[1] It is commonly seen an implantation failed after receiving embryos with good quality, indicating the pivotal role of endometrial receptivity in the implantation process. There are increasing studies focus on performing endometrial injury (EI) in luteal phase to improve endometrial receptivity. Some studies demonstrated that performing EI in luteal phase prior to in vitro fertilization (IVF)/ICSI improved implantation and clinical pregnancy rates,[2,3,4,5,6,7,8,9,10] in the there are some studies denied such benefit of EI.[11,12,13,14,15,16] It is important to point out that most previous studies focused on fresh embryo transfer
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