Endometrial Injury and Fertility Increase in Patients with Recurrent Failed Assisted Reproduction Attempts

The aim of this systematic review is the collection and presentation of all scientific data to date, regarding the effectiveness of the intrauterine injury in cases of repeated failed attempts of conception, through in vitro fertilization. A systematic review of studies evaluating the association between intrauterine injury and increased fertility in women with recurrent failed IVF attempts was performed, in the databases Medline, PubMed, Embase, Google Scholar and Cochrane Central Registry, with regard to information about the fertility potential of these women. The data of the studies analyzed in the present study, indicate that there is a significant correlation between endometrial injury and increased fertility in women with repeated failed IVF attempts. Hysteroscopy with endometrial tissue damage, or the use of a suction pipette catheter during the menstrual cycle that precedes the ovarian stimulation for a subsequent IVF / ICSI, can highly improve the implantation and clinical pregnancy rates in women with failed IVF attempts. The application of local endometrial injury at the cycle preceding the ovarian stimulation for IVF/ICSI, especially during the luteal phase, seems to enhance the endometrial receptivity to the implanted fetus. The endometrial injury may induce changes in the endometrium that are thought to be able to improve the outcomes of the assisted reproduction efforts. Future RCTs are required in order to establish the integration of this therapeutic approach in ART protocols.