The effect of endometrial injury on VEGF gene expression in patients with repeated implantation failure: A randomized control trial

Background: Human embryo implantation is mediated by a complex interaction between embryo and endometrium, which is necessary for successful pregnancy. The failure of implantation may be decreased endometrial receptivity, defective embryonic development or both of them. Repeated implantation failure (RIF) is an unknown major barrier of fertility in infertile women. It is assumed that a defective receptive endometrium is the main cause of RIF. Many strategies have been done to improve the implantation rate in RIF patients. Endometrial injury (EI) is one of these procedures which recently received more attention. However, the mechanisms of EI remains controversial. It seems EI can trigger angiogenesis which is an important aspect of successful implantation. On the other hand, vascular endothelial growth factor (VEGF), as an angiogenic factor, was closely involved in endometrial receptivity and embryo implantation.Objective: The aim of this study was to determine the effects of EI in follicular phase on VEGF gene expression in patients suffering from RIF.Materials and Methods: A total of twenty women with RIF who failed to conceive during two or more IVF/ICSI cycles and embryo transfer (ET) participated in this randomized controlled trial (RCT) study. Pipelle endometrial sampling was done twice: One in the follicular phase as endometrial injury and another in the luteal phase of same menstrual cycle in case group (n=10). Endometrial sampling was done once in control group (n=10) just in the luteal phase for genomic evaluation. Total RNA was extracted from endometrial tissues, then VEGF gene expression was investigated by quantitative real-time PCR.Results: In this study we examined the effect of EI on VEGF gene expression. This study showed that VEGF was detected in endometrial samples of both groups in luteal phase. The mean relative expression of VEGF gene was statistically higher in the case group in comparison to control group at the same time.Conclusion: As a whole, our study provided molecular evidence that patients with repeated implantation failure can benefit from local injury in follicular phase of menstrual cycle before ongoing IVF cycle.

کلیدواژه ها:

Endometrial injury ، RIF ، VEGF ، Embryo Implantation