Endometrial injury for women with previous in vitro fertilization failure - does it improve pregnancy rate?

Implantation failure is one of the major factors limiting success of in vitro fertilization (IVF) treatment. According to ESHRE 2009 data only 32% of fresh embryo transfers resulted in clinical pregnancies. There are many ideas to improve the treatment outcomes, endometrial injury being one of them. It has been suggested that local endometrial injury, performed either by pipelle biopsy or hysteroscopy, may increase clinical pregnancy rate. However, up to date literature is widely disparate on that subject. There is no conclusion with regard to optimal timing, the number and technique of the procedure. The following paper is the review of the evidence from clinical studies dealing with the effect of endometrial injury on the IVF outcome to guide clinical practice for this challenging problem. PubMed, Embase, the Cochrane Library using Medical Subject Headings and free text terms were searched up to June 2016 without year restriction. Though the majority of trials showed positive impact of endometrial injury on IVF outcome, there is still a lack of strong evidence to support routine local endometrial injury in women prior to IVF treatment.