Efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

GOU Jiang ,  REN Juan , ZHAO Jing

Xi'an Fourth Hospital, Xi'an, 710004, P.R.China;

Corresponding author：

REN Juan, Email: ren18325@163.com

Keywords：

Endometrial scratching; Endometrial biopsy; IVF/ICSI; Repeated planting failure; Clinical pregnancy rate; Meta-analysis; Systematic review; Randomized controlled trial; Cohort study

DOI：

10.7507/1672-2531.201807021

Video：

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Objectives To systematically review the efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure in vitro fertilization.Methods PubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect clinical controlled studies on the efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure from inception to March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.Results A total of 10 studies, including 8 randomized controlled trials and 2 case-control studies, and involving 1 274 patients were included. The results of meta-analysis showed that: the clinical pregnancy rate of endometrial mechanical stimulation group was higher than that of control group (RR=1.40, 95%CI 1.04 to 1.89, P=0.03). However, no significant differences were found in implantation rate (RR=0.75, 95%CI 0.50 to 1.13, P=0.17), live births rate (RR=1.38, 95%CI 0.99 to 1.93, P=0.06), miscarriage rate (RR=0.83, 95%CI 0.55 to 1.24, P=0.36) and rate of multiple pregnancy (RR=0.90, 95%CI 0.61 to 1.35, P=0.63).Conclusion Current evidence shows that, for patients with repeated implantation failure, mechanical endometrial stimulation before re-transplantation may help to improve the clinical pregnancy rate of test-tube infants, however, it has no significant effects on implantation rate, live birth rate, abortion rate, multiple pregnancy rate and ectopic pregnancy rate. Due to limited quality and quantity of the included studies, more high quality studies are needed required to verify above conclusions.

Citation： GOU Jiang, REN Juan, ZHAO Jing. Efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure: a systematic review. Chinese Journal of Evidence-Based Medicine, 2019, 19(3): 318-323. doi: 10.7507/1672-2531.201807021 Copy

1.	杨世俊. 体外受精助孕前子宫内膜搔刮对临床妊娠率的影响. 医学理论与实践, 2015, (8): 1078-1079.
2.	Aflatoonian A, Baradaran BR, Hosseinisadat R. The effect of endometrial injury on pregnancy rate in frozen-thawed embryo transfer: A randomized control trial. Int J Reprod Biomed (Yazd), 2016, 14(7): 453-158.
3.	Shokeir T, Ebrahim M, El-Mogy H. Hysteroscopic-guided local endometrial injury does not improve natural cycle pregnancy rate in women with unexplained infertility: Randomized controlled trial. J Obstet Gynaecol Res, 2016, 42(11): 1553-1557.
4.	王安然, 吴洪波, 李柳铭, 等. 子宫内膜浅表机械刺激对 IVF-ET 者子宫内膜血流动力学及妊娠结局的影响. 广西医科大学学报, 2013, 30(2): 240-242.
5.	Tk A, Singhal H, S Premkumar P, et al. Local endometrial injury in women with failed IVF undergoing a repeat cycle: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol, 2017, 214: 109-114.
6.	Shahrokh-Tehraninejad E, Dashti M, Hossein-Rashidi B, et al. A randomized trial to evaluate the effect of local endometrial injury on the clinical pregnancy rate of frozen embryo transfer cycles in patients with repeated implantation failure. J Family Reprod Health, 2016, 10(3): 108-114.
7.	Baum M, Yerushalmi GM, Maman E, et al. Does local injury to the endometrium before IVF cycle really affect treatment outcome? Results of a randomized placebo controlled trial. Gynecol Endocrinol, 2012, 28(12): 933-936.
8.	Narvekar SA, Gupta N, Shetty N, et al. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study. J Hum Reprod Sci, 2010, 3(1): 15-19.
9.	Karimzadeh MA, Ayazi Rozbahani M, Tabibnejad N. Endometrial local injury improves the pregnancy rate among recurrent implantation failure patients undergoing in vitro fertilisation/intra cytoplasmic sperm injection: a randomised clinical trial. Aust N Z J Obstet Gynaecol, 2009, 49(6): 677-680.
10.	Gibreel A, El-Adawi N, Elgindy E, et al. Endometrial scratching for women with previous IVF failure undergoing IVF treatment. Gynecol Endocrinol, 2015, 31(4): 313-316.
11.	Siristatidis C, Kreatsa M, Koutlaki N, et al. Endometrial injury for RIF patients undergoing IVF/ICSI: a prospective nonrandomized controlled trial. Gynecol Endocrinol, 2017, 33(4): 297-300.
12.	Yeung TW, Chai J, Li RH, et al. The effect of endometrial injury on ongoing pregnancy rate in unselected subfertile women undergoing in vitro fertilization: a randomized controlled trial. Hum Reprod, 2014, 29(11): 2474-2481.
13.	Barash A, Dekel N, Fieldust S, et al. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril, 2003, 79(6): 1317-1322.
14.	Zhou L, Li R, Wang R, et al. Local injury to the endometrium in controlled ovarian hyperstimulation cycles improves implantation rates. Fertil Steril, 2008, 89(5): 1166-1176.
15.	Zygula A, Szymusik I, Grzechocinska B, et al. Endometrial injury for women with previous in vitro fertilization failure - does it improve pregnancy rate? Neuro Endocrinol Lett, 2016, 37(6): 419-426.
16.	Potdar N, Gelbaya T, Nardo LG. Endometrial injury to overcome recurrent embryo implantation failure: a systematic review and meta-analysis. Reprod Biomed Online, 2012, 25(6): 561-571.
17.	Safdarian L, Movahedi S, Aleyasine A, et al. Local injury to the endometrium does not improve the implantation rate in good responder patients undergoing in-vitro fertilization. Iran J Reprod Med, 2011, 9(4): 285-288.
18.	项燕, 明蕾, 李春燕, 等. 机械刺激内膜应用于胚胎移植失败患者对妊娠结局影响的 Meta 分析. 生殖医学杂志, 2015, 24(11): 915-921.
19.	El-Toukhy T, Sunkara S, Khalaf Y. Local endometrial injury and IVF outcome: a systematic review and meta-analysis. Reprod Biomed Online, 2012, 25(4): 345-354.
20.	吕忠梅, 孙炜, 倪俏. 轻刮术改善内膜容受性有效性的 Meta 分析. 中国妇幼健康研究, 2015, (5): 944-948.

1. 杨世俊. 体外受精助孕前子宫内膜搔刮对临床妊娠率的影响. 医学理论与实践, 2015, (8): 1078-1079.
2. Aflatoonian A, Baradaran BR, Hosseinisadat R. The effect of endometrial injury on pregnancy rate in frozen-thawed embryo transfer: A randomized control trial. Int J Reprod Biomed (Yazd), 2016, 14(7): 453-158.
3. Shokeir T, Ebrahim M, El-Mogy H. Hysteroscopic-guided local endometrial injury does not improve natural cycle pregnancy rate in women with unexplained infertility: Randomized controlled trial. J Obstet Gynaecol Res, 2016, 42(11): 1553-1557.
4. 王安然, 吴洪波, 李柳铭, 等. 子宫内膜浅表机械刺激对 IVF-ET 者子宫内膜血流动力学及妊娠结局的影响. 广西医科大学学报, 2013, 30(2): 240-242.
5. Tk A, Singhal H, S Premkumar P, et al. Local endometrial injury in women with failed IVF undergoing a repeat cycle: A randomized controlled trial. Eur J Obstet Gynecol Reprod Biol, 2017, 214: 109-114.
6. Shahrokh-Tehraninejad E, Dashti M, Hossein-Rashidi B, et al. A randomized trial to evaluate the effect of local endometrial injury on the clinical pregnancy rate of frozen embryo transfer cycles in patients with repeated implantation failure. J Family Reprod Health, 2016, 10(3): 108-114.
7. Baum M, Yerushalmi GM, Maman E, et al. Does local injury to the endometrium before IVF cycle really affect treatment outcome? Results of a randomized placebo controlled trial. Gynecol Endocrinol, 2012, 28(12): 933-936.
8. Narvekar SA, Gupta N, Shetty N, et al. Does local endometrial injury in the nontransfer cycle improve the IVF-ET outcome in the subsequent cycle in patients with previous unsuccessful IVF? A randomized controlled pilot study. J Hum Reprod Sci, 2010, 3(1): 15-19.
9. Karimzadeh MA, Ayazi Rozbahani M, Tabibnejad N. Endometrial local injury improves the pregnancy rate among recurrent implantation failure patients undergoing in vitro fertilisation/intra cytoplasmic sperm injection: a randomised clinical trial. Aust N Z J Obstet Gynaecol, 2009, 49(6): 677-680.
10. Gibreel A, El-Adawi N, Elgindy E, et al. Endometrial scratching for women with previous IVF failure undergoing IVF treatment. Gynecol Endocrinol, 2015, 31(4): 313-316.
11. Siristatidis C, Kreatsa M, Koutlaki N, et al. Endometrial injury for RIF patients undergoing IVF/ICSI: a prospective nonrandomized controlled trial. Gynecol Endocrinol, 2017, 33(4): 297-300.
12. Yeung TW, Chai J, Li RH, et al. The effect of endometrial injury on ongoing pregnancy rate in unselected subfertile women undergoing in vitro fertilization: a randomized controlled trial. Hum Reprod, 2014, 29(11): 2474-2481.
13. Barash A, Dekel N, Fieldust S, et al. Local injury to the endometrium doubles the incidence of successful pregnancies in patients undergoing in vitro fertilization. Fertil Steril, 2003, 79(6): 1317-1322.
14. Zhou L, Li R, Wang R, et al. Local injury to the endometrium in controlled ovarian hyperstimulation cycles improves implantation rates. Fertil Steril, 2008, 89(5): 1166-1176.
15. Zygula A, Szymusik I, Grzechocinska B, et al. Endometrial injury for women with previous in vitro fertilization failure - does it improve pregnancy rate? Neuro Endocrinol Lett, 2016, 37(6): 419-426.
16. Potdar N, Gelbaya T, Nardo LG. Endometrial injury to overcome recurrent embryo implantation failure: a systematic review and meta-analysis. Reprod Biomed Online, 2012, 25(6): 561-571.
17. Safdarian L, Movahedi S, Aleyasine A, et al. Local injury to the endometrium does not improve the implantation rate in good responder patients undergoing in-vitro fertilization. Iran J Reprod Med, 2011, 9(4): 285-288.
18. 项燕, 明蕾, 李春燕, 等. 机械刺激内膜应用于胚胎移植失败患者对妊娠结局影响的 Meta 分析. 生殖医学杂志, 2015, 24(11): 915-921.
19. El-Toukhy T, Sunkara S, Khalaf Y. Local endometrial injury and IVF outcome: a systematic review and meta-analysis. Reprod Biomed Online, 2012, 25(4): 345-354.
20. 吕忠梅, 孙炜, 倪俏. 轻刮术改善内膜容受性有效性的 Meta 分析. 中国妇幼健康研究, 2015, (5): 944-948.

Chinese Journal of Evidence-Based Medicine

Efficacy and safety of local endometrial mechanical stimulation in patients with recurrent embryo implantation failure: a systematic review

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