الفهرس 
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Abstract
Successful implantation depends on synchronization between the developmental stages of the embryo itself and the complex series of molecular and cellular events that are induced in the pregnant uterus by paracrine and autocrine regulators.
Recurrent implantation failure (RIF) is determined when transferred embryos fail to implant following several in vitro fertilization (IVF) treatment cycles. However, there are no formal criteria defining the number of failed cycles or the total number of embryos transferred in these IVF attempts. Accordingly, different fertility centers practicing IVF may use different definitions for RIF.
Causes of recurrent implantation failure include embryo quality, endometrial receptivity, immunological factors, uterine, tubal and peritoneal factors, and culture media. Poor response to superovulation and chromosomal aneuploidy due to advanced maternal age negatively affect embryo quality, suboptimal embryos are less likely to implant. The “cross-talk” between the embryo and the endometrium that finally leads to apposition, attachment and invasion of embryos is mandatory for successful implantation and subsequent normal placentation. Any abnormality attributed to the embryo, the endometrium or the immune system will result in implantation failure. Therefore, in assessing RIF, the embryo should be evaluated, with reference to the uterus and its functional endometrium. Accordingly, treatment of RIF should be targeted to the abnormality detected, and the correction of any potential malfunction that might contribute to the failure of implantation.
The aim of this work was to assess the effect of endometrial injury before ICSI on implantation and pregnancy rates.
This study was conducted on 180 infertile patients scheduled for ICSI-ET. The patients were divided into three groups.
group A: 60 patients will undergo underwent endometrial sampling
group B: 60 patients underwent office hysteroscopy
group C: 60 patients as a control.
In our study we found that Local endometrial injury in the nontransfer cycle increases significantly the implantation rate and non significantly increases the pregnancy rate in the subsequent IVF-ICSI cycle.