Efecto De La Estimulación Endometrial En La Tasa De Exito En Pacientes Sometidas A Fertilización In Vitro
[Effect Of Endometrial Stimulation On Success Rate In Patients Submitted To In Vitro Fertilization ]

Lorna M Frazer Moreira, Felipe A Morales Martinez, María E. Monrreal Alanís, Otto H. Valdés Martinez, Cesar D. Castro Reyes, Luis H. Sordia Hernández

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Resumen


Introducción: A pesar de los avances en las técnicas de reproducción asistida, la tasa de éxito en fertilización in vitro (FIV) sigue siendo modesta. La lesión endometrial, mediante histeroscopía o biopsia, previo a un ciclo de FIV, ha sido propuesta como una técnica que aumenta la probabilidad de implantación exitosa y embarazo en mujeres sometidas a FIV. Objetivo: Estudiar el efecto de la estimulación endometrial en la tasa de éxito de FIV. Métodos: Se realizó un estudio unicéntrico observacional, en pacientes sometidas a su primer ciclo de FIV. Se incluyeron mujeres entre las edades de 18-40 años que planeaban someterse a FIV con sus propios ovocitos sin exposición reciente a procedimientos disruptivos uterinos. Las pacientes elegibles se dividieron en 3 grupos. El primer grupo incluyó las que se sometieron a una histeroscopía diagnóstica previa a su ciclo de FIV, el segundo grupo incluyó aquellas que se sometieron a biopsia endometrial con cánula de Pipelle previo al ciclo de FIV y el tercer grupo incluyó a las pacientes sin intervención endometrial. Resultados: Se estudiaron un total de 68 pacientes (10 en el grupo 1, 27 en el grupo 2 y 31 en el grupo 3). La tasa de embarazo clínico fue estadísticamente similar en los tres grupos (33.3% para el primer grupo, 15.7% para el segundo y 16.6% para el tercero, p = 0.93). Conclusión: La estimulación endometrial antes del primer ciclo de FIV no ofreció beneficios adicionales en relación con implantación exitosa y/o tasas clínicas de embarazo.
Palabras clave: lesión endometrial, fertilización in vitro, implantación, infertilidad, nacido vivo

 

Abstract
Background: Despite advances in assisted reproduction techniques, the in vitro fertilization (IVF) success rate still remains modest. Endometrial injury, through hysteroscopy or biopsy, prior to an IVF cycle, has been proposed as a technique that increases the likelihood of successful implantation and pregnancy in women undergoing IVF. Objective: To study the effect of endometrial stimulation on the success rate of IVF. Methods: An ambispective observational unicentric study was conducted in patients undergoing their first IVF cycle. Women between the ages of 18-40 who planned to undergo IVF with their own oocytes without recent exposure to uterine disruptive procedures were included. Eligible patients were divided into 3 groups. The first group included those who underwent a diagnostic hysteroscopy prior to their IVF cycle, the second group included those who underwent endometrial biopsy with a Pipelle cannula prior to the IVF cycle and the third group included patients without endometrial intervention. Results: A total of 68 patients were studied (10 in group 1, 27 in group 2 and 31 in group 3). The clinical pregnancy rate was statistically similar in the three groups (33.3% for the first group, 15.7% for the second group and 16.6% for the third group, p = 0.93). Conclusion: Endometrial stimulation before the first IVF cycle did not offer additional benefits in relation to successful implantation and / or clinical pregnancy rates

Keywords: endometrial injury, in vitro fertilization, implantation, infertility, live birth


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Revista de la Federación Centroamericana de Asociaciones y Sociedades de Obstetricia y Ginecología. Editorial Infomedic International ISSN: 0428-0911   - Soporte técnico