Short-term copper intrauterine device placement improves the implantation and pregnancy rates in women with repeated implantation failure

Copper intrauterine device placement for two men- strual cycles at the time of hysteroscopy can improve the implantation and pregnancy rates in women with repeated implantation failure.

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Volume 108, Issue 1, Pages 55–61.e1


Xiaoyan Mao, M.D., Jie Zhang, M.D., Qiuju Chen, Ph.D., Yanping Kuang, M.D., Shaozhen Zhang, M.S.



To study if hysteroscopy and short-term copper intrauterine device placement (Cu-IUD) improves the pregnancy rates of women with repeated implantation failure (RIF) undergoing frozen-thawed embryo transfer (FET).


Retrospective study.


Medical university hospital.


Infertile women with at least two implantation failures with the use of at least one good-quality embryo.


All patients received operative hysteroscopy in the follicular cycle, and if endometrial polyps, polypoid endometrium, or intrauterine adhesions were found they were removed. In some patients, a Cu-IUD was inserted immediately after hysteroscopy and removed after two menstrual periods before embryo implantation. All patients underwent in vitro fertilization or intracytoplasmic sperm injection and FET.

Main Outcome Measure(s)

Clinical pregnancy and implantation rates.


A total of 440 women with a mean age of 33.42 ± 4.45 years (range 23–47 y) were included. There were 382 patients (554 cycles) in the IUD group and 58 patients (87 cycles) in the non-IUD group. The two groups were similar regarding age, body mass index, and infertility factors. The IUD group had a significantly higher implantation rate (29.29% vs. 16.56%), chemical pregnancy rate (53.25 vs. 41.38%), and clinical pregnancy rate (45.13% vs. 26.44%) than the non-IUD group. Multivariable regression analysis indicated that the odds of a chemical pregnancy was significantly increased with IUD usage.


Cu-IUD placement for two menstrual cycles at the time of hysteroscopy can improve the implantation and pregnancy rates in women with RIF.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.


Go to the profile of Micah J Hill
over 3 years ago

Could you give us an idea of why some patients were given the IUD and others were not.  Given that its roughly 7:1 ratio of IUD:non-IUD, what was the general clinical reasoning behind this decision?  Also, how much do you think the second look hysteroscopy played a roll versus the IUD itself?