Effect of local endometrial injury on pregnancy outcomes in ovum donation cycles

Design: Retrospective cohort analysis of ovum donation cycles conducted from 2005 to 2012.

Objective: To evaluate the effect of local endometrial injury (LEI) on clinical outcomes in ovum donation recipients.

Setting: Two private IVF centers.

Patient(s): Total 737 ovum donation cycles.

Intervention(s): LEI by endometrial "scratch" with the use of a Pipelle catheter.

Main Outcome Measure(s): Clinical pregnancy and live birth rates.

Result(s): No statistically significant differences were found in clinical pregnancy rates and live birth rates in cycles subjected to LEI compared with those without. Combination of LEI with fibroid uterus resulted with significantly higher clinical pregnancy rates compared with LEI in normal uterine anatomy.

Conclusion(s): This is the first study done in ovum recipients who underwent LEI by a "scratch" procedure after failed implantation. Unlike most previous reports, which found improved pregnancy rates with the use of "scratch effect" or "minor endometrial injury" after repeated implantation failures in standard IVF with own eggs, we did not find any changes in implantation rates in a population of egg recipients following this procedure. In view of a possible positive effect of LEI in cycles with a previous four or more failures, prospective randomized controlled studies are warranted to better define the target population who may benefit from this intervention.