***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background : Implantation is considered as the rate-limiting step in success of assisted reproduction techniques , and intrauterine insemination cycles . It might be affected by ovarian superovulation and endometrial local scratching . Objective : This study aims to investigate the effect of local endometrial injury on the outcome of IUI cycles . Material s and Methods : In this r and omized clinical trial 144 women with unexplained infertility , mild male factor , and mild endometriosis r and omly divided into two study groups through block r and omization . The patients were r and omly assigned to undergo endometrial biopsy between days 6 - 8 of the previous menstrual cycle before IUI ( n=72 , IUI cycles = 126 ) or receive no interventions ( n=72 , IUI cycles=105 ) . Results : The pregnancy rate per patient was 17 ( 23.6 % ) and 14 ( 19.4 % ) in endometrial biopsy and control groups , respectively ( p=0.686 ) . The pregnancy rate per cycle was 17/126 ( 13.5 % ) and 14/105 ( 13.3 % ) in endometrial biopsy and control groups , respectively ( p=0.389 ) . The abortion rate was comparable between the two groups ( 6.9 % vs. 9.7 % ; p=0.764 ) . The ongoing pregnancy rate was found to be comparable between the two study groups , as well ( 16.7 % vs. 9.7 % ; p=0.325 ) . Endometrial thickness ( p=0.609 ) was comparable between the groups ; however E2 was significantly lower in the endometrial biopsy group ( p<0.001 ) . Conclusion : Application of local endometrial injury in the cycle before the IUI cycles is not associated with increased pregnancy rate per patient and per cycle , decreased abortion , and increased endometrial thickness OBJECTIVE To explore the possibility that endometrial injury modulates the expression of specific genes that may increase uterine receptivity . DESIGN Controlled clinical study . SETTING Clinical IVF unit and academic research center . PATIENT(S ) IVF patients with 28- to 30-day menstrual cycles . INTERVENTION(S ) Endometrial biopsies from two groups of patients were collected on days 20 - 21 of their spontaneous menstrual cycle . The experimental , but not the control , group underwent biopsies on days 11 - 13 and 21 - 24 of their preceding cycle . MAIN OUTCOME MEASURE(S ) Global endometrial gene expression and specific analysis of uroplakin Ib ( UPIb ) mRNA level throughout the menstrual cycle . RESULT ( S ) Local injury modulated the expression of a wide variety of genes . One of the prominently up-regulated genes was the bladder transmembranal protein , UPIb , whose expression by the endometrium is shown here for the first time . Endometrial UPIb mRNA increases after biopsy in the same cycle wct 2with an additional elevation in the following cycle . Immunohistochemical analysis localized the UPIb protein to the gl and ular-epithelial cells . Genes encoding other membrane proteins such as adipose differentiation-related protein and mucin 1 , transmembrane , were also up-regulated . CONCLUSION ( S ) The biopsy-induced increase in the expression of UPIb and other genes encoding membrane proteins supports the possible importance of the membrane structure and stability during implantation . The specific role of UPIb in uterine receptivity should be eluci date Objective The aim of this work was to compare the pregnancy rates during IUI cycles with or without endometrial sampling . Study design A prospect i ve , r and omized study . Patients and methods 150 patients were recruited . They were classified into three groups . Each comprised 50 patients . Group 1 was considered the control group and underwent IUI with no endometrial sampling . Group 2 underwent Tao Brush endometrial sampling on day 8–9 of the uterine cycle that preceded the stimulation cycle , and finally , Group 3 underwent Tao Brush endometrial sampling on day 8–9 of the same IUI cycle Outcome of the study A positive pregnancy test . Results Pregnancy percentages were 18 , 38 , and 36 % for group 1 , group 2 , and group 3 , respectively . The paired t test was used to compare each two individual group means . The results show a highly significant value for the paired t test of the control group and group 2 of the patients ( p = 0.001 ) , as well as a highly significant results ( p = 0.002 ) for the group 3 and the control group . No significant value was present between the group 2 and 3 of patients ( p = 0.322 ) . Conclusion Endometrial sampling significantly increases pregnancy rates in IUI procedures when it is done in the proliferative phase of the IUI cycle , or the cycle prior to IUI , than pregnancy rates with IUI alone OBJECTIVE : The objective was to evaluate the effect of endometrial biopsy ( EB ) on  intrauterine insemination ( IUI )  outcome in controlled ovarian stimulation ( COS ) cycle . DESIGN : Prospect i ve r and omized control study . SETTING : Tertiary care center . MATERIAL S AND METHODS : A total of 251 subjects were enrolled in the study . Subjects undergoing COS with IUI  were r and omly allocated into three groups . Group A : EB was taken between D19 and 24 of the spontaneous menstrual cycles that precedes the fertility treatment and IUI , which was done in next cycle ( n = 86 ) . Group B : EB was taken before D6 of the menstrual cycle , and fertility treatment and IUI was done in the same cycle ( n = 90 ) . Group C : ( control group ) no EB in previous 3 cycle ( n = 75 ) . MAIN OUTCOME MEASURE : Clinical pregnancy rate ( CPR ) . RESULTS : Clinical pregnancy rate was 19.77 % , 31.11 % , and 9.3 % for Group A , Group B , and Group C , respectively . The results show a highly significant value for the paired t-test of intervention Group B and control Group C of the cases ( P = 0.000957 ) . CPR was maximum afterfirst cycle of ovulation induction and IUI following EB scratch in both Groups A and in Group B ( P < 0.001 ) . CONCLUSIONS : Endometrial biopsy done in early follicular phase in the same cycle of stimulation with IUI gives better CPR as compared with EB done in the luteal phase of the previous cycle Purpose To study the effect of endometrial scratching in infertile couples undergoing ovulation induction and intrauterine insemination ( IUI ) cycles . Methods A prospect i ve r and omized controlled trial was conducted in the Department of Obstetrics and Gynaecology , AIIMS , New Delhi , India . One hundred forty-four women with primary / secondary infertility were recruited . Couples were either unexplained or male factor infertility . Subjects were r and omized into intervention ( scratching ) and control group . All patients received ovulation induction with clomiphene citrate ( day 2–6 ) 50 mg/day + 75 IU HMG on days 6 and 7 . In addition , endometrial scratching was done on day 8 of ovulation induction cycle in intervention group . All couples were planned for three cycles of ovulation induction and IUI over 6 months . After each failed cycle , couple was advised to try for natural conception for one cycle . Those who conceived were excluded from further analysis . Primary outcome was clinical pregnancy rate . Secondary outcome measures included conception rate , ongoing pregnancy , abortion and ectopic rate . Results Baseline characteristics were comparable in both groups . Clinical pregnancy rate was significantly higher in intervention group ( 31.9 % ; 23/72 ) as compared to control group ( 16.7 % ; 12/72 ) ( p value 0.030 ) . On per cycle analysis , first IUI cycle had significantly high pregnancy rate ( 18.1 % ; 13/72 ) as compared to control group ( 5.6 % ; 4/72 ) . Three patients in intervention group and one in control group conceived in wash out cycle . Ongoing pregnancy rate was significantly higher in scratching group ( 30.0 % ; 21/70 ) as compared to control group ( 15.7 % ; 11/70 ) ( p value0.044 ) . Conclusions Endometrial scratching can be used as a low cost-effective tool to improve clinical pregnancy and ongoing pregnancy rate in IUI cycles . Further large number studies are required to document its role in improving live birth rate . Trial registration numbe rCT OBJECTIVES To determine the implantation success of local endometrial injury in patients undergoing intrauterine insemination following ovulation induction with gonadotropins as an infertility treatment . MATERIAL AND METHODS In this prospect i ve r and omized controlled trial , ovulation induction was performed with gonadotropins in 80 patients following intrauterine insemination .  In 40 patients , local endometrial injury ( scratch ) was performed in the midluteal phase of the cycle preceding ovarian stimulation with a Novak curette to the posterior side of the endometrial cavity . RESULTS Fifteen pregnancies ( 37.5 % ) and 11 clinical pregnancies ( 27.5 % ) occurred in the intervention group , whereas eight pregnancies ( 20 % ) and five clinical pregnancies ( 12.5 % ) occurred in the control group . Although the pregnancy rates and clinical pregnancy rates were increased in the intervention group , no statistically significant difference was found between the intervention and control groups ( pregnancy rates : P=0.084 ; clinical pregnancy rates : P=0.094 ) . CONCLUSION Performing local endometrial injury ( scratch ) in the cycle preceding ovulation induction in patients with a diagnosis of infertility and indication for intrauterine insemination increased the pregnancy and clinical pregnancy rates . This increase was not , however , statistically significant . More r and omized , controlled , prospect i ve studies with larger patient numbers are required before the use of iatrogenic induction of local endometrial injury can be recommended in routine clinical practice AIM Endometrial scratch injury ( ESI ) has been recently proposed to enhance the implantation rate in assisted reproductive technology cycles . The present study was conducted to determine the effect of ESI on pregnancy rate in women with intrauterine insemination ( IUI ) failure . METHODS This prospect i ve r and omized controlled study was carried out in Imam-Khomeini Hospital and Royan Institute , Tehran , during a 12-month period from January 2013 to January 2014 . After assessment , 169 patients who had IUI failure twice or more ( no chemical or clinical pregnancy ) with normal uterine anatomy and hysterosalpingography , were enrolled . They were r and omly assigned into two groups . In the experimental group , all patients underwent ESI at day 8 or 9 of stimulation phase in the present IUI cycle , whereas no intervention was performed on the control group .  IUI outcome was then compared between the two groups . RESULTS A total of 150 patients completed the IUI cycle during the study . The chemical pregnancy rate was 10.7 % and 2.7 % in the experimental and control groups , respectively , without significant difference ( P = 0.09 ) . Also no significant differences were detected in terms of clinical pregnancy and miscarriage rates between the two groups ( P > 0.05 ) . CONCLUSIONS No significant beneficial effect of ESI  on fertility outcome in patients with repeated IUI failure was detected when it was carried out on day 8 or 9 of the same IUI stimulation cycle . Also , however , no negative impact secondary to ESI was observed . Therefore , confirmation or refutation of this hypothesis requires further studies with a larger sample size . I RCT 201507271141N19 OBJECTIVE To explore the possibility that local injury to the endometrium in controlled ovarian hyperstimulation cycle improves the incidence of embryo implantation and to analyze the gene expression profile in the endometria of pregnant and nonpregnant patients in in vitro fertilization/embryo transfer ( IVF-ET ) . DESIGN Prospect i ve study . SETTING A clinical assisted reproductive center of a university hospital . PATIENT(S ) Women undergoing fresh IVF-ET cycles ( n = 121 ) , treated with a long protocol for controlled ovarian hyperstimulation , whose endometrium were diagnosed by B-ultrasound showing irregular echo . INTERVENTION(S ) Local injury to the endometrium of 60 patients in controlled ovarian hyperstimulation cycle , who were r and omly selected from a total of 121 patients . Seven endometrial biopsies sample s from day 10 were analyzed by Affymetrix U133 plus 2.0 gene chip . MAIN OUTCOME MEASURE(S ) Outcomes of IVF-ET and gene expression assayed by gene chip technology . RESULT ( S ) Transfer of the same number of embryos ( 135 in the experimental and control patients , respectively ) result ed in rates of implantation ( 33.33 % vs. 17.78 % ) , clinical pregnancy ( 48.33 % vs. 27.86 % ) , and ongoing or live births per ET ( 41.67 % vs. 22.96 % ) that were higher in the experimental group compared with controls . Statistically significant differences of the expression level of 218 genes ( 41 up-regulated and 177 down-regulated ) were detected in the endometrial biopsy sample s from clinical pregnant 
    Output:
    
Interestingly , subgroup analysis showed that performing ESI during ovarian stimulation cycle ( C-ESI ) was beneficial ( both in terms of clinical and ongoing pregnancy rates ) , while performing ESI during the cycle before ovarian stimulation ( P-ESI ) did not produce any reproductive advantage .