Impact of mechanical endometrial injury on clinical pregnancy rates in women with clomiphene-resistant polycystic ovary syndrome

Aim: In this study, it was aimed to evaluate the effect of mechanical endometrial injury before letrozole treatment on clinical pregnancy rates in patients with clomiphene-resistant polycystic ovary syndrome (PCOS). Material and Methods: Thirty women with PCOS who could not achieve ovulation despite 150 mg of clomiphene citrate (CC) daily were included in the study. Patients in the PCOS group were equally divided into two groups before letrozole treatment (n=15). Group 1: Endometrial injury was performed with a pipelle cannula in the midluteal phase, and letrozole treatment was started in the next cycle. Group 2: In this group of patients endometrial injury was not performed. Letrozole treatment was started in these patients in the next cycle. Twenty patients with unexplained infertility were taken as a control. Results: Beta hCG was found positive in 4 of 15 patients with endometrial injury in the PCOS group (26.6%). Beta hCG was found positive in 3 of 15 CR-PCOS cases who did not undergo injury (20%). Although beta hCG positivity was higher in the injury group, the difference was not significant (p=0.34). Clinical pregnancy was detected in 3 cases (20%) in patients with injury in the PCOS group. Similarly, clinical pregnancy was detected in 3 of the patients without injury (20%). In the control group, beta hCG positivity and clinical pregnancy rate were detected in 2 out of 10 patients with mechanical endometrial injury (20%). Discussion: Mechanical endometrial injury before letrozole treatment does not increase clinical pregnancy rates both in women with clomiphene-resistant PCOS and unexplained infertility.