Endometrial scratch

When should someone consider an endometrial scratch?

At TFP, we offer a procedure called an endometrial scratch. Some studies have suggested that the endometrial scratch may improve implantation rates. However, other studies have found that there is no difference. Embryo implantation into the womb may fail due to poor embryo quality or irregular embryo genetics. It can also often fail due to poor ‘endometrial receptivity’, which is where the lining of the womb does not provide favourable conditions for the embryo to implant.

HFEA guidance

The HFEA advise that there is conflicting evidence to suggest the endometrial scratch increases pregnancy rates during IVF treatment. For more information please see the HFEA advice and contact us if you would like to discuss this further.

What is an endometrial scratch procedure?

The endometrial scratch is a straightforward outpatient procedure that is relatively painless (similar to a cervical smear test). The procedure involves “scratching” the endometrial lining of the womb with a very small catheter (plastic tube) prior to an attempt to get pregnant.

How does the procedure help with implantation?

The procedure is thought to increase the immune system cells and, therefore, the growth factors at the site of the endometrial scratch. This is believed to make the womb lining more receptive to embryo implantation. The HFEA suggests there could be up to a 5% increase in pregnancy rates. More information can be found on their website.

When should an endometrial scratch be done?

It is recommended that the endometrial scratch is performed in the cycle before you start stimulation medication. Ideally, the procedure should be done between days 19 and 25 of your menstrual cycle.

What if I want to try and conceive naturally?

The scratch can be performed in the same cycle as one in which you are trying to conceive naturally.

How is the procedure performed?

You will attend the clinic with a semi-full bladder (drink 300ml of water 1 hour prior to the procedure, and do not empty your bladder during this time). First, the doctor will perform an internal ultrasound scan to assess the shape and position of the womb. A very small catheter will then be inserted through the cervix into the womb. This catheter will be used to scratch four areas on the womb lining. You may experience slight discomfort as the catheter is being passed into the womb.

What should I expect after the procedure?

After the procedure, a small amount of vaginal spotting or bleeding is not unusual. You can commence an IVF cycle as normal the following month or try a natural cycle in the same month.

Are there risks?

According to current knowledge, there are no known risks from the procedure for the patient or the embryo. Of course, our experienced doctors will take the time to explain the treatment to you in detail. Contact the clinic of your choice – we look forward to seeing you!