Endometrial Scratch – An itch worth scratching?

April 13, 2017

by Dr. Rob Downer, Clinical Embryologist

I’m reading the article ‘Endometrial Scratch Appears Beneficial in Couples Trying to Conceive’, and I’m thinking ‘yeah, yeah… we’ve heard it all before, the next best thing that promises to improve pregnancy success rates, but fails to deliver’.

But hold on a second… I can see real facts, figures, scientific data, live birth rates. Maybe there’s something in this. I’m interested now, so I read further:

Endometrial scratching appeared to increase the chance of clinical pregnancy and live birth compared to no procedure or a placebo procedure; the difference in outcome was statistically significant and appeared to roughly double the chance of live birth compared to no intervention.

Published at the annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) in July this year, this article included properly controlled studies comprising the treatment of 1180 women and it concluded that women can double their chance of having a baby if they had an endometrial scratch.

What’s an endometrial scratch?

Well, the endometrium is the lining of the womb that thickens each month in preparation for pregnancy and then is shed away each month in the form of menstruation. When we say ‘endometrial scratch’ it’s exactly as it sounds… we place a small tube up through the cervix and into the womb and damage or scratch the womb lining. Sounds painful? Yes, it can be and participants in the study rated the pain as 6/10. Endometrial scratch can be performed in your fertility clinic and is usually completed in the month prior to your planned pregnancy. Why does this work? We’re not fully sure, but it’s thought that by damaging the endometrium it changes the immune response in the womb lining and makes it more favourable for receiving an embryo.

Endometrial scratch is a relatively cheap (between €200 and €300) and quick procedure that can be performed at your fertility clinic without sedation. While it won’t work for everyone, for some women endometrial scratching might make all the difference.

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