Endometrial Scratching and IVF

IVF is a complex treatment where not all of the cycles are successful. After several unsuccessful IVF attempts, intended parents often ask about alternative treatment techniques and endometrial scratching is one of them.

What is Endometrial Scratching?

The inner side of the uterus is lined by the endometrium. One of the most crucial parts of pregnancy is implantation – the process when fertilized egg attaches itself to the endometrium. Pregnancy is at a very high risk unless this process completes successfully. This is why, when talking about infertility, miscarriages and other related subjects, implantation failure is always so commonly heard of.
Back to endometrial scratching, you may have guessed correctly that the procedure involves “damaging” the endometrium on purpose. The main idea is to make a small disruption in order to increase the chances of a successful implantation.

The performance itself is no different than an endometrial biopsy which is performed with the thin tube, known as pipelle catheter. The tube is inserted through the cervix in the uterus and will cause a disruption with gentle movements and rotation. Although the description may sound as if the process is painful, it is not true and no anaesthetic is required. However, doctors will usually recommend taking the pain medication to avoid post procedural discomfort.

The procedure is the best when performed about a week prior to the IVF cycle.

How can endometrial scratching support IVF?

Causing a disruption in order to achieve a better result can be confusing. The biological background and the process is still not very well investigated and the odds of increasing the chances of a pregnancy are not yet proven. The logic is however the following : any scratch or injury on the body provokes a repairing reaction. Endometrium too, is not an exception. Scratching is causing an inflammatory response and the healing process of the endometrium is thought to improve the environment for implantation.

When may endometrial scratching be recommended?

Not a lot of data and evidences are available around this subject. A huge, complex studies are ahead to firmly conclude that the endometrial scratching increases the chance of pregnancy and guarantees a higher success rate in IVF.

From the existing examples , the experience shows that endometrial scratching is not so effective in women with one failed IVF cycle. However, it has shown better results for patients who have had two or more failed IVF cycles.

The fertility specialists will unlikely recommend endometrial scratching to patients who are new to the treatment or have had implantation problems only once. Even though the procedure is not expensive, complicated or painful, it is still a discomfort. On the other hand, if there is a history of several failed IVF cycles, your fertility doctor may feel that endometrial scratching could be helpful in your case and is a procedure worth including in your treatment.