The effects of endometrial scratch on the endometrium in recurrent implantation failure

Purpose: Success of IVF in patients with recurrent implantation failure (RIF) depends on the harmonious development of the endometrium and blastocyst. It has been suggested that among the causes of RIF (Recurrent Implatation Failure) are the problems associated with the embryo and endometrium. In women with RIF, evaluation of endometrial factors comes to the fore, since pregnancy does not occur despite good quality of embryo transfering. The endometrium accepts the embryo within the time period so-called 'implantation window'. Although many studies have been published showing that endometrial damage caused by biopsy from the endometrium with the help of a pipette increases endometrial receptivity, the mechanism by which endometrial damage does this is not clearly known. Material and Methods: In our study, 19 patients who diagnosed with RIF were evaluated between the 19th and 21st days of the menstrual cycle. It was determined that there was no structural and histological pathology of the endometrium by diagnostic hysteroscopy between days of 01-22 and the material taken was evaluated for immunohistochemical evaluation for endometrial receptivity markers LIF, integrin αvβ3, estrogen alpha receptor, and electron microscopy for pinopod formations. Endometrial sampling materials for the study of response to treatment were also evaluated for markers of endometrial receptivity in the same patient group in the next cycle again between 19-21 days. Comparisons were made by taking the results of the endometrial receptivity reference group, which consisted of women who could conceive without any endometrial pathology and could become pregnant without treatment. Findings and Conclusion: It was determined that the ultrastructural findings in the endometrium of patients with RIF, which were different from those of fertile women before injury, turned into features similar to the endometrium of fertile women after injury. Immunohistochemically, it was determined that LIF levels increased with injury, and Estrogen alpha receptor and Integrin αvβ3 levels did not differ significantly with injury.