***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 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 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 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 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 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 Background : Though Assisted Reproductive Techniques have overcome many fertility disorders , implantation is still considered , the rate-limiting step for the success of IVF . Aim 0 : The aim of this study was to evaluate the role of endometrial scratching in improving the implantation rate in patients undergoing IVF-ET cycles . Design : Prospect i ve r and omized control trial . Methods and Material : Sixty infertile women with a history of > 1 previous failed IVF-ET cycles were r and omizedinto two groups of 30 each . The patients in group 1 underwent endometrial scratching once between days 14 - 21 of menstrual cycle in the cycle prior to embryo transfer ( ET ) , while in group 2scratching were not done . Implantation rate , ongoing pregnancy rate , abortion rate and live birth rate were comparedbetween both groups . Statistical Analysis : Mean values were compared between two groups using Student′s′t′ independent test . Frequency distributions of categorical variables were compared using Chi-Square/ Fisher′s exact test as appropriate . Results : Implantation rate in group 1 was 19.4 % whereas in group 2 it was 8.1 % . Difference between two groups was statistically significant ( P = 0.028 ) . The live birth rate was higher in the group 2 compared to group 1 , however this difference was not statistically significant ( 3.3 % vs 10 % , P = 0.612 ) . No significant difference was observed between the two groups regarding the ongoing pregnancy rate ( 16.7 % vs 0.0 % ; P = 0.052 ) , abortion rate ( 10.0 % vs 3.3 % , P = 0.612 ) and miscarriage rate ( 6.7 % vs 3.3 % , P = 0.99 ) . Conclusions : Implantation rate increases significantly after endometrial scratching in patients with previous failed IVF-ET Abstract The purpose of this study was to find out whether endometrial scratching could improve live birth rate in women with previous IVF failure undergoing fresh IVF cycle . In a r and omized controlled trial , 387women with previous IVF failure were divided into two groups . Group A ( 193 women ) was subjected to endomet 
    Output:
    
SUMMARY Overall , data from properly design ed and powered r and omized controlled studies demonstrate no beneficial effect of this intervention that is based on unknown biological effects .