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Randomized Controlled Trial
. 2020 Mar;46(3):451-458.
doi: 10.1111/jog.14193. Epub 2020 Jan 30.

Effect of endometrial injury during menstruation on clinical outcomes in frozen-thawed embryo transfer cycles: A randomized control trial

Zhixia Tang  1   2 , Mingyun Hong  2 , Fang He  2 , Dayan Huang  2 , Zhijun Dai  2 , Henghua Xuan  2 , Hong Zhang  1 , Weipei Zhu  1
Affiliations
Randomized Controlled Trial

Effect of endometrial injury during menstruation on clinical outcomes in frozen-thawed embryo transfer cycles: A randomized control trial

Zhixia Tang et al. J Obstet Gynaecol Res. 2020 Mar.

Abstract

Aim: To explore the clinical effect of endometrial injury (EI) on the third day of the menstrual cycle before frozen-thawed embryo transfer (frozen-thawed ET) on patients experienced two or more implantation failures.

Methods: A total of 200 patients who suffered at least two failed hormone-replacement therapies and frozen-thawed ET were randomly divided into two groups: EI group and control group (n = 100 in each group). Patients in the EI group received local EI with a Pipelle catheter on the third day of the menstrual cycle before frozen-thawed ET. Primary outcomes were live birth, clinical pregnancy and implantation rates. Secondary outcomes were biochemical, multiple and ectopic pregnancy rates and abortion rates.

Results: The rate of live birth in EI group (51.00%) was significantly higher than that of control group (36.00%) (P = 0.032). Clinical pregnancy and implantation rates in EI group were significantly higher comparing to control group (64.00% vs 48.00%, P = 0.023 and 46.74% vs 30.11%, P = 0.001). The rate of multiple pregnancy in EI group (37.50%) was significantly higher than that of control group (18.75%) (P = 0.031). No significant difference in ectopic pregnancy rate and abortion rate was observed between EI group and control group.

Conclusion: Applying EI to patients experienced two or more implantation failures on the third day of the menstrual cycle before frozen-thawed ET can improve clinical outcomes.

Keywords: endometrial injury; frozen-thawed embryo transfer; implantation rate; pregnancy rate.

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Figures

Figure 1
Figure 1
Flow chart of the study recruitment process. The exclusion criteria were: history with pelvic surgery history, history with difficult ET and aged more than 40 years; intrauterine abnormality (severe adhesions, uterine polyp, submucosal fibroma), body mass index (BMI) > 27 kg/m2, hydrosalpinx, endometriosis and receiving oral contraception drugs recently.
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