Endometrial Activation

A new procedure improves the chances of IVF success

At the New England Fertility Institute we continually evaluate new research and keep abreast of medical breakthroughs in the field of reproductive endocrinology and infertility. Incorporating research into our practice allows us to contribute to the body of knowledge and advance the medical treatment of couples suffering from infertility.

Over the past year we have evaluated a new procedure meant to improve the chances of implantation and successful pregnancy in IVF cycles.

The procedure named “Endometrial Activation” was the result of research preformed in Israel by a team of scientists led by Dr. Nava Dekel of the world renowned Weitzman Institute in Rehovot, Israel.

Dekel’s research team found that performing an endometrial biopsy (endometrial injury) prior to an IVF cycle increases the chances of pregnancy.

These findings were in fact contrary to the common perception that endometrial injury might inhibit implantation and was therefore taken with a healthy degree of skepticism by the medical community.

The initial finding was serendipitous and followed a research project in which endometrial biopsies were performed in 12 women who have had failed IVF cycles to try and understand the reason for their lack of success. Eleven of the 12 women conceived on a subsequent cycle, a findings that was quite surprising.

The research team theorized that biopsy incisions led to the positive outcome. The team decided to repeat the biopsies on a group of 45 women and compared the results to a control group of 89 women who did not undergo biopsy. The finding indicated the procedure doubled a woman’s chance of becoming pregnant.

Further research by other groups including our own confirmed their findings. The scientists did further investigation to try and elucidate the exact mechanism by which endometrial injury improves implantation. They have discovered that the injury activates a certain gene, which in turn stimulates the production of a specific protein from the endometrium. That protein is believed to be responsible for these findings.

As a result of these studies, Dekel’s team proposed that some mild distress or injury to the uterus might cause more favorable conditions for implantations.

Dekel’s research was reported in the Journal of Fertility and Sterility in June 2003. Since then numerous studies have supported the original outcomes. In Israel endometrium intended injuries have become standard in the practice of IVF.

At the New England Fertility Institute we have gained considerable experience with this procedure and are gearing up to make it a standard part of our IVF process. An endometrial biopsy will be performed during the “Rest Down” cycle, the cycle that precedes the actual IVF. We believe that this simple procedure will offer better success to all patients and particularly to those patients with unexplained infertility or those whose prior treatment attempts have been unsuccessful.