For an IVF/ICSI cycle to be successful, in addition to good quality embryos it is also important that the lining of the womb (endometrium) where the embryo is going to implant is favourable.

Recent studies have suggested that a simple procedure called “endometrial scratch” can boost the chances of successful implantation.

What is endometrial “scratch”?

Endometrial scratch is a simple outpatient procedure where a doctor/nurse uses a fine catheter to remove/scratch the lining of the womb. This instrument is already in common use within gynaecology for a biopsy from the endometrial lining. The procedure is usually planned in the second half of the cycle immediately preceding the IVF attempt.

How is it performed?

It involves vaginal examination with a speculum (like you have while having a cervical smear) and passing a very thin plastic tube called “endometrial pipelle” through the cervix to reach the endometrium. The pipelle is then moved up and down on the walls of the womb. A biopsy may be obtained which may be sent for further examination.

You will be asked to attend with a semi-full bladder and will have an internal scan to assess the shape and position of the womb before and/or during the procedure.

What to expect?

During the examination a slight cramp (similar to period pain), may be felt within the lower tummy. Simple pain relief like paracetamol or ibuprofen can be taken to ease discomfort. You may experience light bleeding or spotting for a few days after the procedure.

How does this work?

Precisely how this may help (if it helps…) is not known. There are a number of theories. Some feel that the lining of the womb may be over mature in response to the stimulation drugs and that this procedure may synchronise it with the embryo being transferred. Others have suggested that this trauma or scratch to the lining of the womb may sensitise the immune cells and release growth factors that promote better development of the lining of the uterus and induce changes that make it more receptive for embryo implantation.

Who should be having it?

There is ongoing research regarding selection of patients for the procedure, the timing and frequency; and best method of endometrial “scratch”. It is clear that this procedure should not be performed in all women. We wish to offer this to women where recurrent unexplained failed IVF cycle has occurred despite good quality eggs and embryos.

For further advice please speak to the doctor at your Genesis clinic appointment or ring for advice on 01132063102.