Endometrial Curettage Before Embryo Transfer
Summary
Studies have shown that endometrial sampling in the month prior to embryo transfer may increase pregnancy rates. We wish to test this hypothesis by performing a hysteroscopy and curettage in the month proceeding embryo transfer during IVF, IVF/ICSI or Frozen/Thawed cycles.
Description
It has been suggested that local injury to the endometrium doubles the rate of implantation and successful pregnancies in IVF patients.
Purpose
1. To determine whether performing curettage the month prior to embryo transfer (ET) increases the chance of embryo implantation.
2. To study molecular attributes of the endometrium taken at curettage and to compare them to those cycles resulting in pregnancy and those which do not result in pregnancy.
Samples will be grown as primary culture in the research laboratory and possible molecular markers and attachment assays for endometrial receptivity will be studied.
Patient selection: Patients undergoing IVF or IVF-ICSI at Ha'Emek medical center/ IVF unit. Woman over 35 years of age will be excluded since implantation failure is more likely to be due to genetic, chromosomal or cytoplasmic aberrations in their oocytes.
Proposed protocol:
1. Informed consent obtained from prospective candidates.
2. Participants randomly divided to three groups
1. Control group
2. Hysteroscopy and curettage performed on days 15-17 of menstrual cycle
3. Hysteroscopy and curettage performed on days 19-22 of menstrual cycle
3. After the following menses an IVF, IVF-ICSI, or frozen embryo cycle is performed according to the unit's standard protocols.
4. The primary end point of the study will be the implantation rate after ET and the expression of possible molecular markers for endometrial receptivity in the pregnant patients.
Study Design
Allocation: Randomized, Control: Active Control, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Conditions
Infertility
Intervention
Hysteroscopy and Curettage
Location
Department of Obstetrics and gynecology, HaEmek Medical Center
Afula
Israel
18101
Status
Recruiting
Source
HaEmek Medical Center, Israel
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00367367
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Infertility
Inability to reproduce after a specified period of unprotected intercourse. Reproductive sterility is permanent infertility.
Hysteroscopy
Endoscopic examination, therapy or surgery of the interior of the uterus.
Infertility, Male
The inability of the male to effect FERTILIZATION of an OVUM after a specified period of unprotected intercourse. Male sterility is permanent infertility.
Sperm Injections, Intracytoplasmic
An assisted fertilization technique consisting of the microinjection of a single viable sperm into an extracted ovum. It is used principally to overcome low sperm count, low sperm motility, inability of sperm to penetrate the egg, or other conditions related to male infertility (INFERTILITY, MALE).
Klinefelter Syndrome
A form of male HYPOGONADISM, characterized by the presence of an extra X CHROMOSOME, small TESTES, seminiferous tubule dysgenesis, elevated levels of GONADOTROPINS, low serum TESTOSTERONE, underdeveloped secondary sex characteristics, and male infertility (INFERTILITY, MALE). Patients tend to have long legs and a slim, tall stature. GYNECOMASTIA is present in many of the patients. The classic form has the karyotype 47,XXY. Several karyotype variants include 48,XXYY; 48,XXXY; 49,XXXXY, and mosaic patterns ( 46,XY/47,XXY; 47,XXY/48,XXXY, etc.).
Clinical Trials
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PubMed Articles
Is routine hysteroscopy during LLETZ a valuable additional procedure?
We aimed to critically review our experience with the value and risks of a diagnostic hysteroscopy performed in addition to LLETZ. We retrospectively included 442 patients undergoing LLETZ and additio...
"See and treat" hysteroscopy after missed abortion.
Abstract A prospective study was conducted on the incidence of intrauterine pathology after missed abortion diagnosed and treated by hysteroscopy. A hysteroscopy was performed in 100 women four to 12...
Aim: To evaluate the diagnostic accuracy of biopsy by dilatation and curettage in postmenopausal women with abnormal uterine bleeding. Material and Methods: A prospective observational study con...
The reproductive outcome in 41 consecutive patients with cesarean-induced isthmocele and secondary infertility was evaluated prospectively. Patients included menopausal women (mean [SD; 95% CI] age, 3...
Effectiveness of misoprostol for office hysteroscopy without anesthesia in infertile patients.
OBJECTIVE: To evaluate and compare the effectiveness of oral and vaginal misoprostol versus placebo to facilitate office hysteroscopy without anesthesia during infertile diagnostic evaluation. DESIGN:...
