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Effect of local injury to endomtrium on implantation rate among patients undergoing in vitro fertilization/intra cytoplasmic sperm injection

Author(s): Mohammad Javad Alemzadeh Ansari | Marzieh Farimani | Narjes Dibavand | Kambiz Masoumi | Azar Ahmadzadeh

Journal: International Journal of Collaborative Research on Internal Medicine & Public Health
ISSN 1840-4529

Volume: 3;
Issue: 3;
Start page: 180;
Date: 2011;
Original page

Keywords: Biopsy | endometrium | infertile women | implantation | pregnancy

Background: Implantation failure is an important cause of recurrent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) failure. Some studies indicate that local injuries to endometriumby endometrial biopsy in the luteal phase of menstrual cycles lead to increase in implantation rate.Aim & Objectives: The present study was aimed to analyze the effect of local injury to the endometriumby biopsy on the rate of successful pregnancies in infertile women undergoing IVF.Methods: In a randomized prospective study, infertile women referring to Fatemiie Hospital, Hamadan in2008 were selected. The inclusion criteria were all infertile women aged between 20 to 40 years whomthe indication for ART was demonstrated by gynecologist. The exclusion criteria was included history ofcoagulative or hemorrhagic disorders, endometrial thickness less than 7mm or greater than 12mm at hCGinitiation time, presence of uterine malformation, endometrioma, active uterine infections, and ultrasoundevidence of hydrosalpinx. Overall, 96 women were selected and then randomly divided into two groups;50 patients as a case group and 46 patients as a control group. Endometrial biopsy was performed in thecase group at the luteal phase on the days 21-26 of spontaneous menstrual cycles, when gonadotropinreleasinghormone agonist use began. Chemical pregnancy was determined by measuring serum βhCGlevel more than 25 U/L, 15 days after embryo transfer. The SPSS version 15.0 software was used toanalyze the data and differences in the implantation rate between case and control groups were analyzedusing the chi-square test. This study was approved by ethics committee of Hamadan University ofMedical Science.Results: Mean age of patients was 29.67±4.52 years and range of age was between 21 to 38 years. Fifteendays after embryo transfer, positive serum βHCG was seen in 21 patients treated by biopsy before IVFand in 9 patients from control group. Number of patients treated by biopsy before IVF was significantlymore than the controls (42.0% vs. 19.6%; P=0.03).Study Limitations: Because of paucity of time as well as financial limitations, we could not evaluate therate of clinical pregnancy and live births in both the groups.Conclusion: Local injury leads to increase in endometrial receptivity for implantation and substantiallyleads to increase in pregnancy rate.
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