Liu Wenjie, Tal Reshef, Chao He, Liu Minghui, Liu Ying
Department of Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026, China.
Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, 06510, USA.
Reprod Biol Endocrinol. 2017 Sep 22;15(1):75. doi: 10.1186/s12958-017-0296-8.
Mechanical endometrial injury prior to IVF has been suggested as a means to increase implantation rates by improving endometrial receptivity. However, the effects of endometrial injury in proliferative vs. luteal phase have not been studied before. This study aimed to explore whether endometrial injury in the proliferative phase of the preceding cycle before in vitro fertilization/embryo transfer (IVF-ET) improves the clinical outcomes in unselected subfertile women compared with injury in luteal phase.
A group of 142 patients who were good responders to hormonal stimulation were randomized into four groups: injury group (group A: endometrial injury in proliferative phase, n = 38; group B: endometrium injury in luteal phase, n = 32), and non-injury group as control (group C: non-injury in proliferative phase, n = 36; group D: non-injury in luteal phase, n = 36). Patients in injury groups underwent endometrial injury in either proliferative phase or luteal phase in the preceding cycle before IVF treatment. Clinical outcomes including implantation, pregnancy, and live birth rates were analyzed among the four groups.
The baseline characteristics of the four groups including age, body mass index, duration, type and causes of infertility were similar. There were no significant differences in implantation, clinical pregnancy or live birth rates between injury group and non-injury group. Moreover, there were also no significant differences in implantation, clinical pregnancy, or live birth rates in injury in proliferative phase compared with luteal phase.
Endometrial injury in the cycle preceding IVF of unselected subfertile women does not increase implantation, clinical pregnancy, or live birth rates. Furthermore, there is no significant difference in clinical outcomes between endometrial injury in the proliferative phase and injury in the luteal phase.
This study was retrospectively registered on May 26th, 2017 (ChiCTR-IOR-17011506).
体外受精（IVF）前进行机械性子宫内膜损伤被认为是一种通过提高子宫内膜容受性来提高着床率的方法。然而，此前尚未研究过增殖期与黄体期子宫内膜损伤的效果。本研究旨在探讨在体外受精/胚胎移植（IVF-ET）前一个周期的增殖期进行子宫内膜损伤与黄体期损伤相比，是否能改善未选择的不育女性的临床结局。
将一组对激素刺激反应良好的142例患者随机分为四组：损伤组（A组：增殖期子宫内膜损伤，n = 38；B组：黄体期子宫内膜损伤，n = 32），以及作为对照的非损伤组（C组：增殖期无损伤，n = 36；D组：黄体期无损伤，n = 36）。损伤组患者在IVF治疗前一个周期的增殖期或黄体期接受子宫内膜损伤。分析四组患者的着床、妊娠和活产率等临床结局。
四组患者的年龄、体重指数、病程、不孕类型和原因等基线特征相似。损伤组与非损伤组在着床、临床妊娠或活产率方面无显著差异。此外，增殖期损伤与黄体期损伤相比，在着床、临床妊娠或活产率方面也无显著差异。
未选择的不育女性在IVF前一个周期进行子宫内膜损伤不会提高着床、临床妊娠或活产率。此外，增殖期子宫内膜损伤与黄体期损伤的临床结局无显著差异。
本研究于2017年5月26日进行回顾性注册（中国临床试验注册中心注册号：ChiCTR-IOR-17011506）。
