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Endometrial injury for RIF patients undergoing IVF/ICSI: a prospective nonrandomized controlled trial
Authors:Charalampos Siristatidis  Maria Kreatsa  Nikoleta Koutlaki  George Galazios  Vasileios Pergialiotis  Nikolaos Papantoniou
Affiliation:1. Assisted Reproduction Unit, 3rd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Chaidari, Athens, Greece,;2. Department of Obstetrics and Gynaecology, Medical School, Democritus University of Thrace, Alexandroupolis, Greece, and;3. 3rd Department of Obstetrics and Gynaecology, Medical School, National and Kapodistrian University of Athens, Chaidari, Athens, Greece
Abstract:To evaluate the effect of endometrial injury on clinical outcomes in subfertile women with repeated implantation failures (RIF) undergoing assisted reproduction. In this prospective nonrandomized controlled trial, 103 subfertile women with RIF were included. Fifty-one underwent endometrial injury through hysteroscopy in the early follicular phase of the previous cycle and 52 underwent the standard protocol without any intervention. Live birth and miscarriage were the primary outcomes. Clinical and in vitro fertilization (IVF) cycle characteristics, were also compared between groups. Both groups were comparable in terms of baseline and cycle characteristics. Live birth rates were significantly higher in the study, compared with the control group (18/51 vs. 8/52, odds ratio (OR)?=?0.25; 95% confidence interval (CI)?=?0.10–0.64; p?=?0.020), although miscarriage rates were similar (7/51 vs. 10/52, OR=?0.25; 95%CI=?0.12–0.66; p?=?0.452). The rest of the outcomes parameters were comparable between groups. Logistic regression analysis revealed that endometrial injury and duration of subfertility were independent predictors of live birth after control of other variables (OR?=?2.818; 95%CI?=?1.044–7.605; p?=?0.041 and OR?=?0.674; 95%CI?=?0.461–0.985, p?=?0.042, respectively). Endometrial injury induced through office hysteroscopy in the preceding cycle in subfertile women with RIF improves live birth rates.
Keywords:Assisted reproductive techniques  endometrial injury  repeated implantation failure
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