Cover
Vol. 8 No. 2 (2018)

Published: December 31, 2018

Pages: 1-6

Research Article

Role of Endometrial Scratch in Enhancing Pregnancy Rate of ICSI Cycle Through Its Effect on TNF-α

Fadya K. AL-Jorani 1 Manal T. AL-Obaidi Wasan A. Abdulhameed
1High Institute of Infertility Diagnosis and Assisted Reproductive Technologies, Al- Nahrain University, Baghdad- IRAQ
History
  • Received: September 1, 2018
  • Available Online: December 1, 2018
DOI

https://doi.org/10.28969/IJEIR.v8.i2.r1

Abstract

Background : The overall success rate of assisted reproductive techniques is only about 30% due to certain limiting factors. Endometrial scratching could induce inflammatory response which manifested by the up-regulation of different cyto­ kines and chemokines with subsequent accumulation of immune cells in the in­ jured site. One of the most important cytokine in this regard is TNF-α which was found to induce tissue remodeling by stimulating the production of many other pro-inflammatory cytokines. Objectives: To investigate the role of endometrial injury during the luteal phase before ICSI cycles in the enhancement of pregnancy outcomes. Materials and Methods: This prospective study was undertaken in the High In­ stitute of Infertility diagnosis and Assisted Reproductive Techniques / Al-Nahrain University. All women were undergone ICSI cycles. Women in the intervension group underwent endometrial scratching with a Pipelle catheter in luteal phase preceding cycle. Blood sample was taken before scratch. All patients undergo controlled ovarian hyperstimulation, oocyte retrieval and embryo transfer, anoth­ er blood sample was taken at day of embryo transfer to measure level of TNF-α. Clinical pregnancy rate then evaluation after luteal support of two weeks. Results: The patients in scratch group has higher pregnancy rate (14/23) 60.9% than non intervention group (11/33) 33.3% although not significant (p value 0.057). The results showed that the TNF-α after scratch (54.53±10.2) was significant­ ly higher than before scratch (39.26±14.74) in the same group, as p value was ( <0.001). In addition the TNF-α was significantly higher in scratch group (54.53±10.2) than control (25.91±9.08) as p value was (< 0.001). Conclusion: Induced endometrial local injury is an easy, simple and cost-effec­ tive technique that can be used to improve the uterine receptivity and enhance embryo transplantation.

Keywords

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