***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: 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 BACKGROUND : Management of repeated implantation failure despite transfer of good- quality embryos still remains a dilemma for ART specialists . Scrapping of endometrium in the nontransfer cycle has been shown to improve the pregnancy rate in the subsequent IVF/ET cycle in recent studies . AIM : The objective of this r and omized controlled trial ( RCT ) was to determine whether endometrial injury caused by Pipelle sampling in the nontransfer cycle could improve the probability of pregnancy in the subsequent IVF cycle in patients who had previous failed IVF outcome . SETTING : Tertiary assisted conception center . DESIGN : R and omized controlled study . MATERIAL S AND METHODS : 100 eligible patients with previous failed IVF despite transfer of good- quality embryos were r and omly allocated to the intervention group and control groups . In the intervention group , Pipelle endometrial sampling was done twice : One in the follicular phase and again in the luteal phase in the cycle preceding the embryo transfer cycle . OUTCOME MEASURE : The primary outcome measure was live birth rate . The secondary outcome measures were implantation and clinical pregnancy rates . RESULTS : The live birth rate was significantly higher in the intervention group compared to control group ( 22.4 % and 9.8 % P = 0.04 ) . The clinical pregnancy rate in the intervention group was 32.7 % , while that in the control group was 13.7 % , which was also statistically significant ( P = 0.01 ) . The implantation rate was significantly higher in the intervention group as compared to controls ( 13.07 % vs 7.1 % P = 0.04 ) . CONCLUSIONS : Endometrial injury in nontransfer cycle improves the live birth rate , clinical pregnancy and implantation rates in the subsequent IVF-ET cycle in patients with previous unsuccessful IVF cycles Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Background : Unexplained infertility is still a challenging issue as to its causes , appropriate management and treatment . Evidence implicates early embryopathy or implantation failure as likely causes . Objective : This study aims to investigate the effect of local endometrial injury on pregnancy rate in selected unexplained infertile patients . Material s and Methods : This was a r and omized clinical trial conducted in Shiraz University Infertility Clinic of Ghadir Hospital . A total of 217 women with unexplained infertility aged 23 - 35 years old were r and omly divided into two study groups through block r and omization . After superovulation by clomiphene-citrate and gonadotropins and when the dominant follicles reached 18 - 20 mm , patients were r and omly assigned to undergo endometrial local injury at posterior uterine wall by piplle endometrial sampling ( n=114 ) or mock pipette biopsy ( n=103 ) during pre-ovulatory days ( when spontaneous urinary LH surge was detected ) . Then all the patients were instructed to follow a regularly timed intercourse . Results : The pregnancy rate was significantly higher in the endometrial injury group compared to the control group [ 17/114 ( 14.9 % ) vs. 6/103 ( 5.8 % ) ( OR : 2.83 95 % CI : 1.07 - 7.49 , p=0.03 ] . The abortion rate was comparable between two groups ( 17.64 % vs. 14.28 % ; p=0.701 ) . Conclusion : Local mechanical injury of the endometrium can enhance the uterine receptivity and facilitates the embryo implantation . This simple , easy , and cost effective procedure is worth considering in selective unexplained infertility patients who implantation failure is the likely causes of infertility before complex treatments . This procedure may help reduce psychological tensions and high expenses imposed through such interventions . Registration ID in I RCT : I RCT Aim : To evaluate the effect of local injury to the endometrium during spontaneous menstrual cycles before in vitro fertilization ( IVF ) treatment on implantation and pregnancy rates in women with recurrent implantation failure ( RIF ) . Methods : In a prospect i ve r and omized controlled trial ( RCT ) , a total of 36 patients , with RIF undergoing IVF  , were r and omized to two groups . In 18 patients , endometrial biopsies were performed using a pipelle curette on days 9–12 and 21–24 of the menstrual cycle preceding IVF treatment . In 18 control patients , a cervical pipelle was performed . Results : The implantation rate ( 2.08 % versus 11.11 % ; p = 0.1 ) , clinical ( 0 % versus 31.25 % ; p < 0.05 ) and live births rates ( 0 % versus 25 % ; p = 0.1 ) were lower in the experimental group compared with controls . Conclusion : Our RCT did not find any benefit from local injury to the endometrium in women with a high number of RIFs . Further studies are warranted to better define the target population of patients who may benefit from this procedure OBJECTIVE To investigate the effect of endometrial injury on the clinical pregnancy rate in normoresponders undergoing long agonist protocol intracytoplasmic sperm injection ( ICSI ) cycles with single embryo transfer . STUDY DESIGN Prospect i ve case-control study . METHODS One hundred and eighteen women ( age < 35 years , normoresponders with Grade I or II embryos for transfer ) were included . Women in the intervention group ( n=56 ) underwent endometrial biopsy on Day 3 of the menstrual cycle following downregulation . Women in the control group ( n=62 ) did not undergo endometrial biopsy . RESULTS The clinical and embryological characteristics were comparable in the two groups , and no significant difference was found in the fertilization rates ( 66.32 % in the intervention group vs. 70.23 % in the control group ) . The clinical pregnancy rate was 48.2 % in the intervention group and 29.0 % in the control group ( p=0.025 ) . Endometrial injury may increase the clinical pregnancy rate ( odds ratio 2.27 ) . The ' take home baby ' rates were 33.9 % and 17.7 % in the intervention and control groups , respectively ( p=0.035 ) . CONCLUSION Assisted reproductive technology treatment that is preceded by endometrial injury may increase the clinical pregnancy rate in women undergoing long agonist protocol ICSI cycles with single embryo transfer OBJECTIVE To determine whether luteal phase endometrial transcriptome is altered in obese women during the window of implantation ( WOI ) , considering the presence of infertility , fat distribution and association with polycystic ovary syndrome ( PCOS ) . DESIGN Prospect i ve study . SETTING University-affiliated infertility clinic , between May 2007 and March 2009 . PATIENT(S ) One control group of women with normal weight ( n=4 ) , and four study groups of obese women ( n=6 each one ) according to the association with infertility , PCOS , and ovarian stimulation . INTERVENTION(S ) The endometrium was biopsied 7 days after LH surge or hCG administration in 28 women . MAIN OUTCOME MEASURE(S ) Endometrial gene expression during the WOI . RESULT ( S ) One hundred and fifty-one genes were dysregulated in obese groups compared with controls . This dysregulation was more pronounced when infertility was associated . The biologic processes of these genes belonged mainly to development and regulation of different biological functions such as transcription and bio synthesis . The molecular functions overrepresented were transcription and peptide receptor activity . The endometrium of obese women with PCOS showed dysregulated genes related to biologic processes such as development , morphogenesis , and the immune system , as well as different molecular functions such as protein binding , binding , growth factor activity , and carboxylic acid transmembrane transporter activity . Some of these genes have been previously related to implantation and unexplained infertility . CONCLUSION ( S ) Obese women present a different endometrial gene expression than controls during the WOI , which is more pronounced when infertility or polycystic ovary syndrome are associated OBJECTIVE To study whether an injury-induced inflammation might be the mechanism underlying the favorable effect of endometrial biopsy on the implantation rate in in vitro fertilization ( IVF ) patients . DESIGN Controlled clinical study . SETTING A medical center IVF unit and a research institute . PATIENT(S ) Women undergoing IVF who had previous failed treatment cycles . INTERVENTION(S ) Endometrial sample s were collected from two groups of patients on day 21 of their spontaneous menstrual cycle . The experimental , but not the control group underwent prior biopsy treatment on days 8 or/ and 11 to 13 of that same cycle . MAIN OUTCOME MEASURE(S ) Abundance of immune cells , cytokines/chemokines level , correlation between these parameters and pregnancy outcome . RESULT ( S ) A statistically significantly higher amount of macrophages/dendritic cells ( HLA-DR+ CD11c+ cells ) and elevated proinflammatory cytokines , tumor necrosis factor-α ( TNF-α ) , growth-regulated oncogene-α ( GRO-α ) , interleukin-15 ( IL-15 ) , and macrophage inflammatory protein 1B ( MIP-1B ) , were detected in day-21 endometrial sample s of the experimental group . A direct stimulatory effect of TNF-α on MIP-1B , GRO-α , and IL-15 messenger RNA ( mRNA ) expression was demonstrated . A positive correlation was found between the levels of macrophages/dendritic cells , MIP-1B expression , and TNF-α expression and the pregnancy outcome . CONCLUSION ( S ) A biopsy-induced inflammatory response may facilitate the preparation of the endometrium for implantation . Increased MIP-1B expression could possibly serve for prediction of implantation competence This 
    Output:
    
Discussion The PIP trials are design ed to address the gaps in the utility of endometrial scratching as a treatment for subfertility in three different population s. If the beneficial effect of this intervention can be confirmed in these setting s , endometrial scratching will provide a cost-effective method for helping women and couples to conceive .