Endometrial scratching is a medical procedure that involves the mechanical injury of the endometrial lining of the uterus. The procedure is performed using a small plastic or metal catheter and aims to improve the chances of successful embryo implantation during in vitro fertilisation (IVF) treatment.
UR Vistahermosa is a fertility clinic in Spain that specialises in advanced assisted reproductive technologies, including endometrial scratching. In this article, we will discuss with their experts when endometrial scratching is necessary and how it works.
When is endometrial scratching necessary?
Endometrial scratching is usually recommended for patients who have experienced repeated IVF failures despite having high-quality embryos. This may indicate that there is an issue with the endometrial lining, which is preventing the embryos from implanting successfully. The procedure is also recommended for patients with a thin endometrial lining, as a thicker lining is believed to be more receptive to embryo implantation.
Endometrial scratching may also be recommended for patients with endometriosis, a condition in which the tissue that lines the uterus grows outside of it, causing inflammation and scarring. Endometriosis can interfere with fertility by causing damage to the ovaries, fallopian tubes, and uterus. Endometrial scratching may help to reduce inflammation and improve the chances of successful embryo implantation in patients with endometriosis.
How does endometrial scratching work?
Endometrial scratching is believed to work by triggering a healing response in the endometrial lining, which may make it more receptive to embryo implantation. The procedure involves the mechanical injury of the endometrial lining using a small catheter. This injury triggers a local inflammatory response, increasing blood flow and encouraging new cells in the endometrial lining.
Endometrial scratching is typically performed during the menstrual cycle, a few days before the start of ovulation. The procedure is performed in a similar way to a cervical smear test, and it only takes a few minutes to complete. Patients may experience mild cramping or discomfort during the procedure, but these symptoms usually subside quickly.
After the procedure, patients may be prescribed medication to help support the growth of the endometrial lining. This may include estrogen or progesterone supplements, depending on the patient’s needs. Patients may also be advised to rest for a few days after the procedure to allow the endometrial lining to heal.
What are the risks and benefits of endometrial scratching?
Like any medical procedure, endometrial scratching carries some risks and benefits. The main benefit of endometrial scratching is that it may improve the chances of successful embryo implantation in patients undergoing IVF treatment. Studies have shown that endometrial scratching can increase the pregnancy rate by up to 20% in some patients.
However, endometrial scratching does carry some risks. The procedure can cause mild to moderate pain or discomfort, and some patients may experience cramping or spotting afterwards. In rare cases, endometrial scratching can cause more serious complications, such as infection or damage to the uterus.
Despite these risks, endometrial scratching is generally considered to be a safe and effective procedure. It is a minimally invasive treatment that can be performed in an outpatient setting and has a relatively low risk of complications.
Endometrial scratching is a relatively new procedure that has gained popularity in recent years as a way to improve the success rates of IVF treatment. The procedure is performed by experienced fertility specialists who have a wealth of knowledge and expertise in assisted reproductive technologies.
Before recommending endometrial scratching, the fertility specialists will conduct a thorough evaluation of the patient’s medical history, including any previous IVF treatments and any underlying medical conditions that may be affecting fertility. They will also perform a series of tests to assess the patient’s ovarian reserve, hormone levels, and the thickness of the endometrial lining.
If endometrial scratching is deemed appropriate, the procedure will be scheduled for the optimal time during the menstrual cycle, usually a few days before ovulation. The procedure itself is relatively simple and involves the insertion of a small plastic or metal catheter through the cervix and into the uterus. The catheter is then gently moved back and forth along the endometrial lining, causing a mild injury to the tissue.
The fertility specialists will provide detailed instructions on how to care for the endometrial lining in the days and weeks following the procedure, including any medications or supplements that may be required.
It is important to note that endometrial scratching is not appropriate for all patients undergoing IVF treatment. The procedure may not be recommended for patients with certain medical conditions or those with a history of uterine scarring or trauma. Patients should consult with their fertility specialist to determine if endometrial scratching is right for them.
Endometrial scratching – FAQ
Is uterine scratch successful in IVF?
The evidence on the success of endometrial scratching in IVF is mixed. Some studies have shown a small increase in pregnancy rates with endometrial scratching before IVF, while others have not found any significant improvement. The procedure may be more effective in certain subgroups of patients, such as those with previous failed IVF cycles or recurrent implantation failure. Overall, the success of endometrial scratching in IVF is still being studied and debated within the medical community.
When to do endometrial scratch IVF?
Endometrial scratching is typically performed in the menstrual cycle preceding IVF treatment. This is usually around day 21 of the menstrual cycle, or about a week before the start of IVF medications. However, the timing may vary depending on the individual’s menstrual cycle and the IVF protocol being used. It’s important to discuss the optimal timing with your fertility specialist.
When is the best time for an endometrial scratch?
The best time for endometrial scratching is during the proliferative phase of the menstrual cycle, which is typically days 5-14. This is when the endometrium is growing and developing, and the procedure may help to stimulate the growth of a healthier endometrium. However, for IVF purposes, endometrial scratching is usually performed during the luteal phase of the cycle, which is after ovulation and before menstruation.
Does endometrial scratching improve the IVF pregnancy rate?
Studies have shown conflicting results on whether endometrial scratching improves IVF pregnancy rates. Some studies have reported a small but significant increase in pregnancy rates with endometrial scratching, while others have found no difference. The procedure may be more effective in certain subgroups of patients, such as those with previous failed IVF cycles or recurrent implantation failure. It’s important to discuss the potential benefits and risks of endometrial scratching with your fertility specialist.
Is it worth having an endometrial scratch?
The decision to have an endometrial scratch should be made on an individual basis, taking into account the potential benefits and risks. While some studies have reported a small increase in pregnancy rates with endometrial scratching, others have not found any significant improvement. The procedure is generally safe, but there is a small risk of infection or injury to the uterus. It’s important to discuss the potential benefits and risks with your fertility specialist.
Is scratching in IVF painful?
Endometrial scratching is usually performed under local anaesthesia or conscious sedation to minimise discomfort. Some women may experience cramping or mild pain during or after the procedure, but this is usually short-lived and can be managed with over-the-counter pain relievers.
Do you bleed after an endometrial scratch?
Some women may experience spotting or light bleeding after an endometrial scratch, but this is usually mild and short-lived. It’s important to contact your fertility specialist if you experience heavy bleeding or severe pain after the procedure.
What should I do before an endometrial scratch?
Before an endometrial scratch, you should discuss any medications or supplements you are taking with your fertility specialist. You may need to stop taking certain medications or supplements prior to the procedure. You should also avoid sexual intercourse for a few days before the procedure, and arrange for someone to drive you home after the procedure if you are receiving sedation.
Can endometrial scratching help with implantation?
Endometrial scratching may help to improve the receptivity of the endometrium, which may increase the chances of successful implantation. The procedure may be more effective in certain subgroups of patients, such as those with previous failed IVF cycles or recurrent implantation
In conclusion, endometrial scratching is a safe and effective procedure that may improve the chances of successful embryo implantation in patients undergoing IVF treatment. UR Vistahermosa is a leading fertility clinic that specialises in advanced assisted reproductive technologies, including endometrial scratching. The clinic’s experienced fertility specialists can help patients determine if endometrial scratching is right for them and provide compassionate, personalised care throughout the treatment process.