الفهرس 
ENDOMETRIAL RECEPTIVITYOnly 14 pages are availabe for public view
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Abstract
nfertility is a unique medical condition because it involves a couple, rather than a single individual. It is defined as failure of a couple to conceive after 12 months of regular intercourse without use of contraception in women less than 35 years of age; and after six months of regular intercourse without use of contraception in women 35 years and older.
IUI is a procedure by which washed spermatozoa are introduced into the uterine cavity, thereby bypassing several of the natural barriers in the female genital tract. In combination with, or without, controlled ovarian hyperstimulation, it has proven to be a cost-effective line of treatment for infertility. Its main indications are mild male factor, cervical factor or cases of unexplained infertility.
Implantation of the embryo, which is a prerequisite for successful pregnancy, can only take place in a receptive uterus. In humans, the uterus becomes receptive during the mid-secretory phase of the menstrual cycle (days 19–23), commonly known as the window of implantation (WOI). It is assumed that inadequate uterine receptivity is responsible for approximately two-thirds of implantation failures. Although many fertility disorders have been overcome by a variety of assisted reproductive techniques, implantation remains the rate-limiting step for the success of in vitro fertilization (IVF) Successful embryonic implantation implies anchoring the conceptus in the maternal uterine wall, establishing a vascular supply to enable optimal growth and development of the conceptus, and promoting the tolerance of fetal alloantigen encoded by paternal genes to achieve these goals, complex molecular dialogs take place among the maternal endometrium, the conceptus, and the placenta. Several factors are involved in the fetal–maternal interaction, including hormones, growth factors, cytokines, chemokines, adhesion molecules, extracellular matrix components, and matrix-degrading enzymes. This study suggested that endometrial local injury using a biopsy catheter on day (5, 6 or 7) of the same controlled ovarian hyperstimulation menstrual cycle combined with the IUI treatment improves the pregnancy rate. This study conducted in Ain Shams University Maternity Hospital (ART unit) from June 2014 and April 2015. The study included infertile women who would have an intrauterine insemination; 176 patients were included and divided randomly into two equal groups of 88 patients, in the biopsy group endometrial local injury using a pipelle biopsy catheter on day (5, 6 or 7) of the same controlled ovarian hyperstimulation menstrual cycle combined with the IUI treatment was done. All patients included in the study were subjected to; detailed history taking and full examination.Basal hormonal profile and seminal fluid analysis were achieved. The endometrial injury was performed in the study group on day (5, 6 or 7) of the same controlled ovarian hyperstimulation (clomid and/ or gonadotropins) menstrual cycle combined with the IUI treatment. All the included patients subjected to controlled ovarian stimulation with IUI. Pregnancy test was done after 14 from the IUI, if positive trans-vaginal ultrasound was done 5 weeks after IUI. The results of this study showed that the pregnancy rates in biopsy group (20%) were significantly higher than the pregnancy rates in control group (8.1%).