Endometrial injury may increase the clinical pregnancy rate in normoresponders undergoing long agonist protocol ICSI cycles with single embryo transfer

Abstract

Objective: To investigate the effect of endometrial injury on the clinical pregnancy rate in normoresponders undergoing long agonist protocol intracytoplasmic sperm injection (ICSI) cycles with single embryo transfer.

Study design: Prospective case-control study.

Methods: One hundred and eighteen women (age <35 years, normoresponders with Grade I or II embryos for transfer) were included. Women in the intervention group (n=56) underwent endometrial biopsy on Day 3 of the menstrual cycle following downregulation. Women in the control group (n=62) did not undergo endometrial biopsy.

Results: The clinical and embryological characteristics were comparable in the two groups, and no significant difference was found in the fertilization rates (66.32% in the intervention group vs. 70.23% in the control group). The clinical pregnancy rate was 48.2% in the intervention group and 29.0% in the control group (p=0.025). Endometrial injury may increase the clinical pregnancy rate (odds ratio 2.27). The 'take home baby' rates were 33.9% and 17.7% in the intervention and control groups, respectively (p=0.035).

Conclusion: Assisted reproductive technology treatment that is preceded by endometrial injury may increase the clinical pregnancy rate in women undergoing long agonist protocol ICSI cycles with single embryo transfer.

Keywords: ART; Clinical pregnancy; Endometrial injury; Single embryo transfer.