Effect of endometrial injury on in vitro fertilization pregnancy rates: a randomized, multicentre study
To determine if endometrial injury prior to the first or second in vitro fertilization (IVF) cycle affects clinical pregnancy rates.
This study was a randomized, multicentre, controlled study performed at three Canadian outpatient fertility clinics. Patients undergoing their first or second IVF cycle were randomized to a single endometrial injury 5–10 days prior to the start of gonadotropins in an IVF cycle compared to no injury. The primary outcome was clinical pregnancy rate. Secondary outcomes were live birth rates, implantation rate, endometrial thickness, number of oocytes retrieved and the rate of embryo cryopreservation.
Fifty-one women were randomized (25 in the en dometrial injury group and 26 in the control group); however, the study was terminated prematurely due to slow recruitment (target 332 patients). Groups were similar at baseline for: age, duration of infertility, BMI, day 3 FSH, and the number having first IVF cycle. The groups were similar for gonadotropin dose, endometrial thickness, number of oocytes retrieved, and embryo cryopreservation rate. The clinical pregnancy rate in the endometrial injury group was 52% (13/25) and 46% (12/26) in the control group (p = 0.45). Live birth rate in the endometrial injury group was 52% (13/25) and 35% (9/26) in the control group (p = 0.17). The implantation rate was also similar (58% vs. 45%, p = 0.17).
This study did not detect a difference in implantation, clinical pregnancy or live birth rates; however, the lack of difference in this study may be because it was underpowered.
Clinical trials registrations
KeywordsEndometrium Local injury IVF outcomes Implantation
This study was supported by an unrestricted Educational Grant from Ferring Inc. (Canada).
JH data collection, data analysis, manuscript writing. KEL protocol development, data collection, manuscript writing/editing. CAL protocol development, data collection, manuscript writing/editing. JH protocol development, data collection, data analysis, manuscript writing/editing.
This study was funded by an unrestricted Research Grant from Ferring Inc. (Canada). (No Grant number was provided).
Compliance with ethical standards
Conflict of interest
J Hilton: No conflicts to declare except for the study funding. KE Liu: No conflicts to declare except for the study funding. CA Laskin: No conflicts to declare except for the study funding. J Havelock: No conflicts to declare except for the study funding.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by The University of British Columbia Clinical Research Ethics Board, Vancouver BC, Canada (#H12-01484) and the Mount Sinai Hospital Research Ethics Board, Toronto ON, Canada (#12-0068-A).
Informed consent was obtained from all individual participants included in the study.
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