the effect of endometrial injury on first cycle ivf/icsi outcome: a randomized controlled trial

background: implantation remains a limiting step in ivf/icsi. endometrial injury isa promising procedure aiming at improving the implantation and pregnancy rates after ivf/icsi. objective: the aim of this study was to evaluate the effect of endometrial injury induced in precedingcycle on ivf/icsi outcome. materials and methods: four hundred patients undergoing their first ivf/icsi cycle in two ivf units in minia, egypt were randomly selected to undergo either endometrial injury in luteal phase of preceding cycle (intervention group) or no treatment (control group). primary outcome wasthe implantation and live birth rateswhile the  secondary outcome was clinical pregnancy, miscarriage, multiple pregnancy rates, pain and bleeding during and after procedure. results: implantation and live birth rates were significantly higher in intervention compared with control group (22.4% vs. 18.7%, p=0.02 and 67% vs. 28%, p=0.03), respectively. there was also a significant reduction in miscarriage rate in intervention group (4.8% vs. 19.7%, respectively, p<0.001). conclusion: endometrial injury in preceding cycle improves the implantation rate and live birth rate and reduces the miscarriage rate per clinical pregnancy in patients undergoing their first ivf/icsi cycle.