Efecto del raspado endometrial (scratching) en pacientes sometidas a ciclos de FIV con ovocitos de donante

Résumé

Embryo implantation is a crucial step in the success of assisted reproductive treatments and depends on the dialogue between a competent embryo and a receptive endometrium. The role of the embryo has been widely studied, and significant improvements have been made in in-vitro culture and embryo selection thanks to morphokinetics and genetics. On the contrary, the role of the endometrium has often been disregarded.The endometrium has an essential implication in the embryo implantation process, which occurs thanks to the synchronization of successive stages in which ovarian hormones have a main role, but many molecular mediators have also been involved. In 1907, the appearance of an endometrial decidualization after performing an injury to the uterine mucosa was described in guinea-pigs. This motivated the hypothesis of a possible modification also in the human endometrium through a mechanical injury, also known as endometrial scratching (ES). The potential mechanisms involved in this effect are the induction of a local inflammatory response, the modulation of endometrial gene expression and the delay in the endometrial maturation, all of which would favor a more receptive endometrium for embryo implantation...