title: The effects of endometrial injury on intrauterine insemination outcome: A randomized clinical trial.
abstract: 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.
  
  
  METHODS
  In this randomized clinical trial 144 women with unexplained infertility, mild male factor, and mild endometriosis randomly divided into two study groups through block randomization. The patients were randomly 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Afsoon
authors.initials: A
authors.lastname: Zarei
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Alborzi
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Nasrin
authors.initials: N
authors.lastname: Dadras
authors.affiliation: Department of Obstetrics and Gynecology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ghazal
authors.initials: G
authors.lastname: Azadi
keywords: Endometrial injury; Female; Infertility; Intrauterine Insemination (IUI); Pregnancy