Does a single endometrial biopsy regimen (S-EBR) improve ICSI outcome in patients with repeated implantation failure? A randomised controlled trial.

OBJECTIVE: To evaluate the effect of a single endometrial biopsy regimen (S-EBR) in the cycle preceding the ICSI cycle in patients with repeated implantation failure.

STUDY DESIGN: This was a prospective randomized controlled trial which included two-hundred infertile women with a history of repeated implantation failure. The subjects were randomly divided into two groups. Group A subjects underwent hysteroscopy and endometrial scraping by Novak curette in the cycle preceding the ICSI cycle, while group B subjects underwent hysteroscopy without endometrial scraping. Implantation rate, clinical pregnancy rate, abortion rate and live birth rate were compared between both groups.

RESULTS: The number of retrieved oocytes in group A was 11.6 ± 3 and in group B was 11.6 ± 2.8 with no statistically significant difference (p=0.787). There were statistically significant differences regarding the implantation rate, the clinical pregnancy rate and live birth rate. The implantation rate in group A was 12% while in group B it was 7% (p=0.015), the clinical pregnancy rate was 32% in group A while it was only 18% in group B (p=0.034) and the live birth rate was 28% in group A while it was 14% in group B (p=0.024).

CONCLUSIONS: The single endometrial biopsy regimen (S-EBR) performed during hysteroscopy has statistically significant higher implantation rate, clinical pregnancy rate and live birth rate than hysteroscopy without endometrial scraping.