Pregnancy Outcomes in Women with Recurrent Miscarriages Following Endometrial Biopsy- a Systematic Review of Literature

Background: Intentional injury to the endometrium is associated with improved chances of live birth in women undergoing assisted reproductive treatment. The effect of endometrial biopsy on women with recurrent miscarriages (RM) is uncertain.

Objectives: The objective of the study was to assess if endometrial biopsy increases the chances of conception and improves pregnancy outcomes in women with RM.

Methods: For this purpose, a systematic review of literature was carried out. Inclusion criteria consisted of studies assessing the effect of any type of endometrial injury in a non-conception cycle on subsequent pregnancy outcomes in women with RM.

Results: Literature search revealed 479 records. No truly randomized studies were identified. One observational retrospective study provided information to allow outcome analysis. In this study of 25 women with RM undergoing ovulation induction, endometrial biopsy was associated with a risk ratio (RR) for on-going pregnancy of 0.73 (95%CI 0.32-1.68). Similarly, RR for miscarriage was 0.26 (0.07-1.03) following EB. Analysis of other outcomes was not possible.

Conclusion: The results of this systematic review indicate the paucity of data related to the effect of endometrial injury on chances of conception and subsequent outcomes of pregnancy in women with RM. Further research is required to asses if this procedure could be incorporated into the treatment workup of women with RM.