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Effects of the removal of menstrual endometrium in ivf et



Effects of the removal of menstrual endometrium in ivf et



Japanese Journal of Fertility & Sterility 37(2): 123-126



The role of endometrial factors in controlling embryo implantation is poorly understood. To clarify the affects of residual endometrium during menstruation in patients undergoing IVF-ET, the endometrium was removed by thorough aspiration (suction curettage) on the third day of menstrual cycle. Thirty nine patients were randomly divided into two groups; aspirated (18 cases) and control (21 cases) groups. The tip of 14Fr-sized catheter was processing as a curettage. The cathether was inserted into uterine cavity and aspirated endometrial tissue so as to cover eventually all of the uterine cavity using 20 ml of disposable syringe. GnRH agonist administration was initiated during luteal phase. The hMG was begun on day 3 of the menstrual cycle. The hCG 10,000 IU was given when at least two follicles measured 18 mm in the largest diameter. There were no significant differences in mean age, infertile factors, cancellated cycle, mean number of collected oocyte and transfered embryos, serum E2, progesterone and endometrial thickness on the day of hCG administration between both groups. On the day of hCG administration, eleven of 15 cases (73%) in the aspirated group showed sonographically leaf-like endometrium characterized by prominent outer and midline hyperechogenic lines and inner hypoechogenic regions, while 6 of 16 cases (38%) in control group showed. Pregnancy rate of 27.8% in the aspirated group was significantly higher than that of 4.8% in control group (p < 0.05). These data suggest that the aspirated removal of menstrual endometrium was favorably effective on achieving pregnancy in IVF-ET.

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