Should I Have an Endometrial Scratch with my Fertility Treatment or IVF?

Almost one in eight women may experience difficulties when trying to get pregnant. Half of these women will seek the help of a fertility specialist. Many Infertility treatments are undertaken in the private sector, and the cost is borne by the patients. There are many fertility treatments such as Insemination, IVF, ICSI, etc.

It is well known that not every Fertility treatment will result in pregnancy. Given the lack of NHS funding, most patients are willing to explore every possible way of maximising the IVF success rate. One possibility is an endometrial scratch. This intervention can help you to optimise your chances of a successful fertility treatment.

What is an endometrial scratch?

It is a minor gynaecological office or outpatient procedure. It is just like having a cervical smear test with your Doctor. The endometrial scratch usually takes no more than fifteen to twenty minutes. Your fertility specialist will give you clear instructions to follow.

The neck of the womb or cervix is visualised, and a fine plastic catheter is passed through the cervix into the womb or uterus. Once the catheter inserted, it is gently moved, and the womb lining or endometrium is scraped. You may experience some degree of discomfort during an endometrial scratch. The feeling is comparable to a bad period cramp. Some women may feel dizzy during or soon after the endometrial scratch. You may also experience mild bleeding which settles in a day.

How does an endometrial scratch improve the IVF success rate or my chance of getting pregnant?

This is the most interesting aspect. Like many aspects of medicine, we do not exactly know how this works. The most likely explanation is that by doing this procedure, the womb or uterus lining is mildly injured. This starts the process of wound healing. The body produces many useful chemical or healing factors. These create a better environment for the embryo to implant following embryo transfer.

When is an endometrial scratch done?

It is planned in the preparatory month before your IVF treatment.  In other words, when you undergo egg collection and embryo transfer.

Do I need to take time off after an endometrial scratch?

No, this is a minor procedure just like a smear test. You may experience some discomfort during and after the procedure. This may be helped by taking paracetamol. As it is a minor procedure, you may return to work after the endometrial scratch. You may also feel free to use public transport or drive if required.

What is the risk of having an endometrial scratch with IVF treatment?

It is a minor procedure and is safe. Less than one percent patients may develop an infection after the procedure. This can be picked up generally within few days of having the endometrial scratch. In most patients, this can be addressed with antibiotics. Your fertility specialist will choose the antibiotics which will not compromise your IVF treatment.

Who should have this procedure?

The procedure is recommended for those patients who have been through a previous failed IVF treatment, also called recurrent implantation failure. Having endometrial scratch with your IVF treatment does not guarantee that the IVF will be successful. Studies have shown, however, that endometrial scratch can maximise the chances. It may even improve the chances with simpler fertility treatment. For example Insemination or Intrauterine insemination. In our practice, it is mainly used for patients with repeated implantation failure or previous failed IVF treatment.