Endometrial scratch

At TFP, we offer a procedure called an endometrial scratch. Some studies suggest that the endometrial scratch may improve implantation rates. However, other studies have found that there is no difference. We discuss what this procedure is and why it may be offered.

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What is an endometrial scratch?

The endometrial scratch is a straightforward outpatient procedure that may cause slight discomfort but is relatively painless (similar to a cervical smear test).

The procedure involves an internal ultrasound scan and then a very small catheter (plastic tube) is used to “scratch” the endometrial lining of the womb prior to an attempt to get pregnant.

patient is blurred out in foreground with a blue cloth over her stomach while a friendly clinical nurse speaks calmly about procedure

Who may benefit from an endometrial scratch?

You may wish to consider an endometrial scratch if you've had a failed embryo implantation.

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.

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 the HFEA website.

a happy couple sit on their sofa smiling at a positive pregnancy test

Treatment

How is the procedure done?

We've outlined what will happen on the day to ease anxiety before your procedure.

The endometrial scratch is straightforward and does not require anaesthetic, though we do recommend that you take painkillers.

woman-looks-outside-holds-coffee-cup-breakfast-sits-out-on-table

Step one

Before your procedure

Drink lots of liquids! We advise that you 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).

Step two

Internal ultrasound

First, the doctor will perform an internal ultrasound scan to assess the shape and position of the womb.

Smiling woman in a plastic apron stands beside an ultrasound machine in a medical setting.

Smiling woman lying on a medical examination bed, hands on her stomach, with ultrasound equipment in the foreground.

Step three

Cather and the endometrial scratch

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.

Step four

What to 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.