Endometrial Biopsy in the Luteal Phase Prior to IVF and ICSI: A Prospective Case Control Study

Author(s): Goeckenjan M, Glaß K, Kramer M, Hartig A, Trinkaus I, Wimberger P

Aims: The diagnostic and therapeutic impact of endometrial biopsy in the luteal phase of the preceding cycle before artificial reproductive technology (ART) was determined in a prospective case control study.

Methods: From 1/2017 until 8/2018 all women treated with ART were asked to participate in the study at a University Fertility Center. 115 endometrial biopsies were performed prior to controlled ovarian stimulation. The endometrial tissue was analyzed immunohistochemically for hCG and CD138 positive plasma cells (CD138+). The results of 84 ART cycles after endometrial biopsy were compared to 204 controls.

Results: The clinical pregnancy rates after or without endometrial biopsy did not differ significantly (35.7 vs. 39.2%, p=0.578). Lower live birth rates were seen after intervention but this difference was not significant (23.8% vs. 32.4%, p=0.150). In 19/84 samples of endometrial tissue CD138+-plasma cells were detected (22.6%). In this group the clinical pregnancy rate was lower than in the group without signs of inflammation (26.3 vs. 38.5%, p=0.337).

Conclusions: A therapeutic benefit of endometrial biopsy in the midluteal phase of the preceding menstrual cycle was not proven for the following ART cycle in this prospective study. Women with signs of chronic endometritis with CD138+-plasma cells showed a reduced clinical pregnancy rate. The detection of CD138+-plasma cells as a marker for impaired implantation should be investigated in larger studies as a routine diagnostic work-up for infertility prior to ART.

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