Clinical background affecting pregnancy outcome following local endometrial injury in infertile patients with repeated implantation failure

Abstract

Local endometrial injury (LEI) has been performed as a promising medical intervention to improve the pregnancy outcome in infertile women suffering from repeated implantation failure (RIF) in in vitro fertilization-embryo transfer cycles. The effect of LEI, however, remains controversial. The aim of this retrospective study was to identify the subgroups of patients with RIF who benefit from LEI. We compared the clinical parameters between the patients who had had a clinical pregnancy in the subsequent embryo transfer cycle following the LEI cycle (LEI-CP group, n = 94) and those who had resulted in negative pregnancy test (LEI-NP group, n = 114). The female age, basal follicle stimulating hormone concentration, number of past oocyte pickup cycles, and embryos/blastocysts transferred in the past three RIF cycles were significantly (p < 0.047) lower in the LEI-CP group than the LEI-NP group. The prevalence of polycystic ovarian syndrome was significantly (p = 0.0059) higher in the LEI-CP group than in the LEI-NP group. These findings suggest that LEI is most effective to improve the pregnancy outcome in patients undergoing RIF with uncompromised ovarian reserve, particularly in those with polycystic ovarian syndrome.

Chinese abstract

子宫内膜局部微损伤(LEI)是一种有前途的医疗干预，可以改善体外受精-胚胎移植

周期中反复胚胎植入失败（RIF）不孕妇女的妊娠结局。但LEI的效果仍有争议。本次回顾性研究的目的是确认运用LEI受益的RIF患者亚组。我们比较LEI周期后进行胚胎移植有临床妊娠的患者(LEI-CP组, n=94)和未妊娠试验的患者(LEI-NP组, n = 114)的临床指标。妇女的年龄、基础卵泡刺激素浓度、取卵数、过去三个RIF周期中植入的胚胎/囊胚数，LEI-CP组明显低于LEI-NP组(p<0.047)。多囊卵巢综合征的患病率LEI-CP组明显高于LEI-NP组(p=0.0059)。这些结果提示LEI对于卵巢储备良好的RIF患者提高妊娠结局最有效，特别是多囊卵巢综合征的患者。

• Endometrium
• infertility
• polycystic ovarian syndrome