Proliferative phase endometrial biopsy in reproductive failure
Research type
Research Study
Full title
Assessing clinical outcome and endometrial (womb-lining) function in biopsies performed in the proliferative compared with the luteal phase of the menstrual cycle in women with reproductive failure.
IRAS ID
230555
Contact name
Niamh Forde
Contact email
Duration of Study in the UK
1 years, 11 months, 28 days
Research summary
Miscarriage is the most common complication of pregnancy; one which can devastate those affected. Recurrent miscarriage affects 1 in 100 couples, while live birth rates following IVF treatment remain just 26%.
An endometrial biopsy (commonly referred to as a 'scratch' of the womb-lining) is a commonly-performed minor procedure, undertaken with the intention of improving implantation rates and lowering pregnancy loss rates at subsequent IVF or natural cycle conceptions.
We currently do not know why minor trauma to the womb-lining might improve subsequent pregnancy rates, but it is thought that the biopsy may alter the population of immune cells or cause an influx of stem cells within the womb-lining. Endometrial scratch, along with assessment of womb-lining cell population, is typically undertaken in the luteal phase (latter third) of the menstrual cycle. Little is known about womb-lining make-up and its cell population at other times of the menstrual cycle.
We hypothesise that an endometrial scratch in the luteal phase may being performed too late to alter the womb lining environment, cell population and receptivity to an implanting pregnancy, and wish to assess if performing this earlier in the cycle (around the time of egg release) can better-promote these changes, and thereby increase the chances of successful implantation and pregnancy outcome.
The aim of this study is to understand if and how performing a mid-cycle (proliferative phase) endometrial biopsy or 'scratch' changes the endometrial environment, improves implantation rates and lowers miscarriage rates.
The study also seeks to ascertain whether there may be a marker in the blood that can be measured as a 'proxy' for activity within the womb-lining, so that in the future a blood test may be all that is required for some, rather than an womb-lining biopsy being necessary.
REC name
North East - York Research Ethics Committee
REC reference
18/NE/0191
Date of REC Opinion
11 Sep 2018
REC opinion
Further Information Favourable Opinion