Objective: The objective of this research was to assess the impact of endometrial injury on pregnancy rates during IVF among patients with recurrent implantation failure (RIF) with an Endobiops sampler or hysteroscopic directed biopsy.

Methods: A retrospective matched cohort analysis was performed. IVF outcome was compared among 44 patients with ≥2 failed IVF cycles undergoing luteal phase endometrial injury in the cycle preceding the current IVF treatment (Group A) to 44 similar patients without intervention (Group B). Stimulation parameters as well as IVF outcome (pregnancy and implantation rates [PR; IR]) were compared using Student’s t-test and chi square tests.

Findings: The two groups were comparable in demographics. Overall ongoing PR (41% vs. 23%, p=0.06) and IR (27% vs. 15%, p=0.08) were higher in Group A, but the difference in ongoing PR was only significant in GnRH antagonist cycles (43% vs. 19%, p=0.04). No differences in the studied parameters were noted between Endobiops sampling versus hysteroscopic endometrial injury.

Conclusions: Endometrial injury improves pregnancy outcomes in subsequent IVF treatment among patients with RIF compared to patients who undergo repeat IVF treatment without. The implications of improved outcomes in GnRH-ant cycles and comparison of Endobiops biopsy to hysteroscopic injury remains to be clarified.