International Journal of
Reproductive Biomedicine
Sat, Apr 20, 2024
[Archive]
Volume 12, Issue 9 (10-2014)
IJRM 2014, 12(9): 647-0 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Zarei A, Alborzi S, Dadras N, Azadi G. The effects of endometrial injury on intrauterine insemination outcome: A randomized clinical trial. IJRM 2014; 12 (9) :647-0
URL: http://ijrm.ir/article-1-579-en.html
URL: http://ijrm.ir/article-1-579-en.html
1- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran
2- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran , dadras.nasrin@gmail.com
2- Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran , dadras.nasrin@gmail.com
Abstract: (2874 Views)
Background: Implantation is considered as the rate-limiting step in success of assisted reproduction techniques, and intrauterine insemination cycles. It might be affected by ovarian superovulation and endometrial local scratching.
Objective: This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles.
Materials and Methods: In this randomized clinical trial 144 women with unexplained infertility, mild male factor, and mild endometriosis randomly divided into two study groups through block randomization. The patients were randomly assigned to undergo endometrial biopsy between days 6-8 of the previous menstrual cycle before IUI (n=72, IUI cycles =126) or receive no interventions (n=72, IUI cycles=105).
Results: The pregnancy rate per patient was 17 (23.6%) and 14 (19.4%) in endometrial biopsy and control groups, respectively (p=0.686). The pregnancy rate per cycle was 17/126 (13.5%) and 14/105 (13.3%) in endometrial biopsy and control groups, respectively (p=0.389). The abortion rate was comparable between the two groups (6.9% vs. 9.7%; p=0.764). The ongoing pregnancy rate was found to be comparable between the two study groups, as well (16.7% vs. 9.7%; p=0.325). Endometrial thickness (p=0.609) was comparable between the groups; however ER2R was significantly lower in the endometrial biopsy group (p<0.001).
Conclusion: Application of local endometrial injury in the cycle before the IUI cycles is not associated with increased pregnancy rate per patient and per cycle, decreased abortion, and increased endometrial thickness.
Objective: This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles.
Materials and Methods: In this randomized clinical trial 144 women with unexplained infertility, mild male factor, and mild endometriosis randomly divided into two study groups through block randomization. The patients were randomly assigned to undergo endometrial biopsy between days 6-8 of the previous menstrual cycle before IUI (n=72, IUI cycles =126) or receive no interventions (n=72, IUI cycles=105).
Results: The pregnancy rate per patient was 17 (23.6%) and 14 (19.4%) in endometrial biopsy and control groups, respectively (p=0.686). The pregnancy rate per cycle was 17/126 (13.5%) and 14/105 (13.3%) in endometrial biopsy and control groups, respectively (p=0.389). The abortion rate was comparable between the two groups (6.9% vs. 9.7%; p=0.764). The ongoing pregnancy rate was found to be comparable between the two study groups, as well (16.7% vs. 9.7%; p=0.325). Endometrial thickness (p=0.609) was comparable between the groups; however ER2R was significantly lower in the endometrial biopsy group (p<0.001).
Conclusion: Application of local endometrial injury in the cycle before the IUI cycles is not associated with increased pregnancy rate per patient and per cycle, decreased abortion, and increased endometrial thickness.
Type of Study: Original Article |
References
1. Almog B, Shalom-Paz E, Dufort D, Tulandi T. Promoting implantation by local injury to the endometrium. Fertil Steril 2010; 94: 206-209. [DOI:10.1016/j.fertnstert.2009.12.075]
2. Dekel N, Gnainsky Y, Granot I, Mor G. Inflammation and implantation. Am J Reprod Immunol 2010; 63: 17-21. [DOI:10.1111/j.1600-0897.2009.00792.x]
3. Basak S, Dubanchet S, Zourbas S, Chaouat G, Das C. Expression of pro-inflammatory cytokines in mouse blastocysts during implantation: modulation by steroid hormones. Am J ReprodImmunol 2002; 47: 2-11. [DOI:10.1034/j.1600-0897.2002.1o047.x]
4. Achache H, Revel A. Endometrial receptivity markers, the journey to successful embryo implantation. Hum Reprod Update 2006; 12: 731-746. [DOI:10.1093/humupd/dml004]
5. Moragianni VA, Penzias AS. Cumulative live-birth rates after assisted reproductive technology. Curr Opin Obstet Gynecol 2010; 22: 189-192. [DOI:10.1097/GCO.0b013e328338493f]
6. Diedrich K, Fauser BC, Devroey P, Griesinger G; Evian Annual Reproduction (EVAR) Workshop Group. The role of the endometrium and embryo in human implantation. Hum Reprod Update 2007; 13: 365-377. [DOI:10.1093/humupd/dmm011]
7. Makker A, Singh MM. Endometrial receptivity: clinical assessment in relation to fertility, infertility, and antifertility. Med Res Rev 2006; 26: 699-746. [DOI:10.1002/med.20061]
8. Arslan M, Bocca S, Mirkin S, Barroso G, Stadtmauer L, Oehninger S. Controlled ovarian hyperstimulation protocols for in vitro fertilization: two decades of experience after the birth of Elizabeth Carr. Fertil Steril 2005; 84: 555-569. [DOI:10.1016/j.fertnstert.2005.02.053]
9. Finn CA, Martin L. Endocrine control of the timing of endometrial sensitivity to a decidual stimulus. Biol Reprod 1972; 7: 82-86. [DOI:10.1093/biolreprod/7.1.82]
10. 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 undergoing in vitro fertilization. Fertil Steril 2003; 79: 1317-1322. [DOI:10.1016/S0015-0282(03)00345-5]
11. Zhou L, Li R, Wang R, Huang HX, Zhong K. Local injury to the endometrium in controlled ovarian hyperstimulation cycles improves implantation rates. Fertil Steril 2008; 89: 1166-1176. [DOI:10.1016/j.fertnstert.2007.05.064]
12. Karimzade MA, Oskouian H, Ahmadi S, Oskouian L. Local injury to the endometrium on the day of oocyte retrieval has a negative impact on implantation in assisted reproductive cycles: a randomized controlled trial. Arch Gynecol Obstet 2010; 281: 499-503. [DOI:10.1007/s00404-009-1166-1]
13. Gnainsky Y, Granot I, Aldo PB, Barash A, Or Y, Schechtman E, et al. Local injury of the endometrium induces an inflammatory response that promotes successful implantation. Fertil Steril 2010; 94: 2030-2036. [DOI:10.1016/j.fertnstert.2010.02.022]
14. Almog B, Shalom-Paz E, Dufort D, Tulandi T. Promoting implantation by local injury to the endometrium. Fertil Steril 2010; 94: 2026-2029. [DOI:10.1016/j.fertnstert.2009.12.075]
15. American Society for Reproductive Medicine. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril 1997; 67: 817-821. [DOI:10.1016/S0015-0282(97)81391-X]
16. Cooper TG, Noonan E, von Eckardstein S, Auger J, Baker HW, Behre HM, et al. World Health Organization reference values for human semen characteristics. Hum Reprod Update 2010; 16: 231-245. [DOI:10.1093/humupd/dmp048]
17. Loeb L.Uberdieexperimentelleerzeugung von knoten von deciduagewebe in dem uterus des meerschweinchensnachstattgefundener copulation. Zbl Allg Path Path Anat 1907; 18: 563-565.
18. Sherer DM, Abulafia O. Angiogenesis during implantation, and placental and early embryonic development. Placenta 2001; 22: 1-13. [DOI:10.1053/plac.2000.0588]
19. Kolb BA, Paulson RJ. The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation. Am J Obstet Gynecol 1997; 176: 1262-1267. [DOI:10.1016/S0002-9378(97)70344-2]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
