The Effect of Local Injury to The Endometrium for Implantation and Pregnancy Rates in ICSI-ET Cycles with Implantation Failure

Zeynep Hafiza Ozturk Inal; Huseyin Gorkemli; Hasan Ali Inal

The Effect of Local Injury to The Endometrium for Implantation and Pregnancy Rates in ICSI-ET Cycles with Implantation Failure

Year 2012, Volume: 9 Issue: 4, 223 - 229, 01.12.2012

Zeynep Hafiza Ozturk Inal Huseyin Gorkemli Hasan Ali Inal

Abstract

To assess the effect of local injury to the endometrium for implantation, pregnancy and live birth rates in ICSI –ET cycles with recurrent implantation failure. The study was prospectively designed and performed in a university hospital. A group of 100 women, who failed to conceive during one or more cycles of IVF and embryo transfer (ET), was treated with a long protocol for controlled ovarian hyperstimulation. The IVF treatment and ET were preceded by repeated endometrial biopsies, in a randomly selected 50 of a total of 100 women. Age of the women, days of stimulation, total dose of gonadotropins, E2 concentrations and endometrial thickness on hCG day, total MII stage oocytes, the total number of high quality embryos for transfer, the day of transfer and the number of embryos transferred were similar for both groups. Transfer of a similar number of embryos (138 and 141 in the experimental and control patients, respectively) resulted in rates of implantation (34.67 % vs. 30.88 %; p= 0,1384) clinical pregnancy (60 % vs. 34 %; p= 0.009), and live births per ET (44 % vs. 24 %; p= 0.03), which were higher in the experimental group as compared to controls. These results suggest that IVF treatment that is preceded by local injury to the endometrium improved the rates of embryo implantation, clinical pregnancy, and live births in asiste reproductive technique.

Keywords

References

Cross JC, Werb Z, Fisher SJ. Implantation and the pla- centa: key pieces of the development puzzle. Science 1994;266:1508–18.
Barash A, Dekel N, Fieldust S, Segal I, Schechtman E, Granot I. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergo- ing in vitro fertilization. Fertil Steril 2003;79(6):1317-22.
Raziel A, Schachter M, Strassburger D, Berno O, Ron-El R, Friedler S. Favorable influence of local injury to the endometrium in intracytoplasmic sperm injection pa- tients with high-order implantation failure. Fertil Steril 2007;87:198–201.
Zhou L, Li R, Wang R, Huang HX, Zhong K. Endometrial injury in COH cycle. Fertil Steril 2008;89(5):1166-76.
Karimzadeh MA, Ayazi Rozbahani M, Tabibnejad N. Endometrial local injury improves the pregnancy rate among recurrent implantation failure patients under- going in vitro fertilization/intracytoplasmic sperm in- jection: a randomised clinical trial. Aust N Z J Obstet Gynaecol 2009;49(6):677-80.
Narvekar SA, Gupta N, Shetty N, Kottur A, Srinivas M, Rao KA. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study. J Hum Reprod Sci 2010;3(1): 15-9.
Demirol A, Gurgan T. Effect of treatment of intrauterine pathologies with office hysteroscopy in patients with re- current IVF failure. Reprod Biomed Online 2004;8:590-4.
Mooney S, Milki A. Effect of hysteroscopy performed in the cycle preceeding controlled ovarian hyperstimula- tion on the outcome of in vitro fertilization. Fertil Steril 2003;79:637-8.
Rama Raju GA, Shashi Kumari G, Krishna KM, Prakash GJ, Madan K. Assessment of uterine cavity by hysteroscopy in assisted reproduction programme and its influence on pregnancy outcome. Arch Gynecol Obstet 2006;274:160-4.
S.D. Spandorfer, Y. Delgado, J. Park, R. Clark and Z. Rosenwaks. The success in IVF when Utilizing Autologous Endometrial Coculture (AECC) is not secondary to a local endometrial injury. Fertil Steril 2005;84:S52-3.
Loeb L.U ber die experimentelle Erzeugung von Knoten von Deciduagewebe in dem Uterus des Meerschweinchens nach stattgefundener Copulation [The experimental proof changes in the uterine decidua of guinea pig after mating]. Zentralbl Allg Pathol 1907;18:563–5.
Humphrey KW. Interaction between estrogen-17_ and progesterone on the induction of deciduomata in ovariec- tomized mice. Aust J Biol Science 1969;22:689–99.
Finn CA, Martin L. Endocrine control of the timing of en- dometrial sensitivity to a decidual stimulus. Biol Reprod 1972;7:82–6.
Basak S, Dubanchet S, Zourbas S, Chaouat G, Das C. Expression of proinflammatory cytokines in mouse blas- tocysts during implantation: modulation by steroid hor- mones. Am J Reprod Immunol 2002;47:2–11.
Karow WG, Gentry WC, Skeels RF, Payne SA. Endometrial biopsy in the luteal phase of the cycle of conception. Fertil Steril 1971;22:482-95.
Friedler S, Margalioth EJ, Kafka I, Yaffe H. Treatable uterin cause for in-vitro fertilisation failures. Lancet 1993;341:1213.
Akita S, Ishihara H, Mohammad Abdur R, Fujii T. Leukemia inhibitory factor gene improves skin allograft survival in the mouse model. Transplantation 2000;70:1026–31.
Gnainsky Y, Granot I, Aldo PB, Barash A, Or Y, Schechtman E et al. Local injury of the endometrium induces an in- flammatory response that promotes successful implanta- tion. Fertil Steril 2010:94(6):2030-6.
Kalma Y, Granot I, Gnainsky Y, Or Y, Czernobilsky B, Dekel N, Barash A. Endometrial biopsy-induced gene modula- tion: first evidence for the expression of bladder-trans- membranal uroplakin Ib in human endometrium. Fertil Steril 2009;91(4)
Song H, Lim H, Paria BC, Matsumoto H, Swift LL, Morrow J et al. Cytosolic phospolipase A2 alpha deficiency is cru- cial for ‘on time’ embryo implantation that directs sub- sequent development. Development 2002;129:2879-89.
Dey S. Reproductive biology fatty link to fertility. Nature 2005;435:34-5.
Dey S, Lim H, Das S, Reese J, Paria B, Daikoku T et al. Molecular cues to implantation. Endocr Rev 2004;25:341-73.
Carson DD, Julian J, Lessey BA, Prakobphol A, Fisher SJ. MUC1 is a scaffold for selection ligands in the human uterus. Front Biosci 2006;11:2903-8.