I am often asked about endometrial scratching and it seems to be the topic of the moment with studies being published recently as to its effectiveness in a treatment cycle, so I thought this would make a great topic for my blog this week.
Well firstly, what is an endometrial scratch? An endometrial scratch is a procedure used to potentially help improve the chance of embryo implantation in the womb after In-Vitro Fertilisation (IVF), Intracytoplasmic Sperm Injection (ICSI) or frozen embryo transfer (FET) cycles. Research has previously shown that disturbing the surface cells of the lining of the womb can stimulate the womb to repair itself in such a way that it becomes more receptive to an implanting embryo. The procedure itself is similar to an embryo transfer or cervical smear.
Since its inception, endometrial scratching has caused controversy amongst clinicians. Most clinics tend to offer the procedure to women who have experienced recurrent embryo implantation failure. However, the treatment has begun to be offered more widely to all IVF patients. There are a number of theories as to why the scratching of the endometrial lining could improve chances of embryo implantations, such as inflammation creating increased receptivity of the lining to embryo implantation. However, there is a distinct lack of evidence for this or any other explanation.
Previous studies performed have suggested that the treatment could increase chances of live birth from 9% to anywhere up to 14-28%. However, these older studies were at high risk of bias, and larger, more reliable studies have since been called for.
The answer to this came in the form of a review study and the findings were recently presented by Dr Sarah Lensen at the Annual Meeting of ESHRE in Barcelona at the beginning of July 2018. This trial was undertaken by 13 different fertility centres, spanning five countries and involved more than 1,300 IVF patients. Half of the patients in the trial were assigned the endometrial scratch and the other half had no scratch. The study concluded that the endometrial scratch had no benefit to live birth rates with both the scratch and no scratch groups having the same percentage of live births. It also however concluded that the endometrial scratch did cause a “moderate amount of pain and bleeding” and the question has now been brought up as to whether endometrial scratches should be offered at all.
Endometrial scratching is usually an add-on treatment offered and the cost can vary considerably between clinics, and it isn’t something that we routinely include in our Assured Plans currently.
Holly Scott, Patient and Clinic Liaison Manager
Assured Fertility provide fast-tracked IVF and egg donation plans with no hidden extras. If you don’t have a baby you get 100% of your money back.*
*subject to acceptance on our plan
