Objectives: To determine outcome of in-vitro fertilization (IVF) on using endometrial scratch (ES) or intrauterine perfusion with HCG (HCG-IUP) in women with recurrent implantation failure (RIF).
Patients & Methods: 93 women were randomly divided into: Control group received no intervention, Group ES were subjected to ES using an endometrial biopsy catheter during the luteal phase of the cycle preceding that of ET and Group HCG-IUP underwent intrauterine perfusion of 500 U of HCG just before embryo transfer (ET). The classic Testart slow freezing and rapid thawing protocol was applied for all women. Study outcomes included the implantation rate (IR), clinical pregnancy rate (CPR) and Frequency of pregnancy loss till 12th gestational week.
Results: Total IR was 38.7% and was 19.4%, 45.2% and 51.6% for control, ES and HCG-IUP groups, respectively. IR was significantly higher in ES and HCG-IUP groups in comparison to control group with non-significantly higher IR in HCG-IUP group. Total CPR was 63.9% and was 50%, 64.3% and 68.8% in study groups, respectively with non-significant inter-group difference. Total miscarriage rate was 30.4% and was 66.7% in control, 33.3% in ES and 18.8% in HCG-IUP with non-significantly higher rate in control group. Conclusion: ES during the luteal phase of the cycle preceding ET or intrauterine perfusion with 500 U of HCG immediately before ET are efficient adjuvant to ovarian stimulation for women with RIF assigned for frozen ET. The reported non-significant differences between the IR with ES or HCG-IUP open the scale for physician preference and skill. |
