Local injury of the endometrium induces an inflammatory response that promotes successful implantation

Abstract

Objective-To study whether an injury-induced inflammation might be the mechanism underlying the favorable effect of endometrial biopsy on the implantation rate in in vitro fertilization (IVF) patients. Design-Controlled clinical study.Setting-A medical center IVF unit and a research institute. Patient(s)-Women undergoing IVF who had previous failed treatment cycles.Intervention(s)-Endometrial samples were collected from two groups of patients on day 21 of their spontaneous menstrual cycle. The experimental, but not the control group underwent prior biopsy treatment on days 8 or/and 11 to 13 of that same cycle.Main Outcome Measure(s)-Abundance of immune cells, cytokines/chemokines level, correlation between these parameters and pregnancy outcome.Result(s)-A statistically significantly higher amount of macrophages/dendritic cells (HLA-DR + CD11c + cells) and elevated proinflammatory cytokines, tumor necrosis factor-α (TNF-α), growthregulated oncogene-α (GRO-α), interleukin-15 (IL-15), and macrophage inflammatory protein 1B (MIP-1B), were detected in day-21 endome-trial samples of the experimental group. A direct stimulatory effect of TNF-α on MIP-1B, GRO-α, and IL-15 messenger RNA (mRNA) expression was demonstrated. A positive correlation was found between the levels of macrophages/dendritic cells, MIP-1B expression, and TNF-α expression and the pregnancy outcome. Conclusion(s)-A biopsy-induced inflammatory response may facilitate the preparation of the endometrium for implantation. Increased MIP-1B expression could possibly serve for prediction of implantation competence.

Effects of endometrial injury on frozen‐thawed blastocyst transfer in hormone replacement cycles

“…However, those reports varied in terms of the characteristics of the device that was used for injury, the degree of injury, and the timing of the intervention. Various devices have been used to injure the endometrium, such as hysteroscopes and biopsy catheters 1, 3, 4, 5, 6, 7, 9. In this study, an endometrial sampler was used that was considered to be an appropriate tool for inducing a mild endometrial injury.…”

“…One possible cause for this is poor endometrial receptivity. Various approaches to addressing this problem have been explored and some recent studies have shown that local endometrial injury can improve both the implantation rates and pregnancy outcomes in patients with unexplained recurrent implantation failure 1, 2, 3, 4, 5, 6, 7, 8, 9…”

63 Effect of Endometrial Biopsy on Uterine Health of Tropically Adapted Beef Cattle

“…Studies in infertile women with repeated implantation failure (RIF) have demonstrated improvement in PR after a mechanical injury caused by EB (Potdar et al, 2012). It is reported that causing mechanical trauma to the endometrium in the cycle before ET (Barash et al, 2003, Karimzadeh et al, 2009 or during the ongoing cycle (Boomsma et al, 2009a, Gnainsky et al, 2010, Huang et al, 2011, actually improves endometrial receptivity and pregnancy success. A systematic review, (Potdar et al, 2012) reported the pregnancy outcomes of seven controlled studies (n=2062) in women with RIF.…”

“…Some controversy exists about the effect of collecting endometrial samples on subsequent reproductive performance. In subfertile women, local endometrial injuries in the cycle before ET improved the pregnancy rates (Barash et al, 2003, Gnainsky et al, 2010. In cattle, some studies suggest that these procedures impair uterine function (Zaayer andVan der Horst, 1986, Etherington et al, 1988) whilst others report satisfactory pregnancy rates but without making a comparison with control non-sampled group (Rhoads et al, 2008, Chapwanya et al, 2010.…”

“…Differences in endometrial transcriptome profile between pregnant and non-pregnant heifers have been identified by assessing endometrial samples collected using CB from the previous cycle (Salilew-Wondim et Introduction xix subsequent influx of inflammatory cells and production of cytokines and growth factors that actually improves the subsequent pregnancy rates (Barash et al, 2003, Almog et al, 2010, Gnainsky et al, 2010, Granot et al, 2012.…”