Does Endometrial Injury Improve Outcomes of Frozen-Thawed Embryo Transfer Cycle? A Meta-Analysis

OBJECTIVE: The effectiveness of endometrial injury in assisted reproductive technology cycles remains a controversial topic. This meta-analysis aims to define the potential efficacy by which endometrial injury is helpful for frozen embryo transfer (FET) cycles. STUDY DESIGN: By searching articles in Pub-Med, Google Scholar, and EMBASE, we retrieved 327 records. According to the inclusion and exclusion criteria, we eventually selected four randomized controlled trials with data for 476 patients undergoing FET cycles. RESULTS: Our meta-analysis revealed that there was a comparable clinical pregnancy rate (RR 1.09, 95% CI 0.86-1.40, p=0.47, I-2 =46%) and a similar live birth rate (RR 1.01, 95% CI 0.73-1.39, p =0.94, I-2 =0%) between endometrial injury procedure and control groups. Meanwhile, there was no significant difference in clinical miscarriage rate (RR 0.96, 95% CI 0.53-1.74, p =0.89, I-2 =0%) between endometrial injury treatment and control groups. CONCLUSION: Endometrial injury did not have a benefit to the outcomes of FET cycles. Nevertheless, more randomized controlled trials are needed to further evaluate the efficacy of adjunctive endometrial injury procedure in FET cycles.