Can an endometrial scratch improve my chances of pregnancy?

For couples undergoing IVF, having a cycle fail despite the transferred embryo being of good quality can sometimes be all the more distressing. They may question if it doesn’t work when all the signs are good, when will it? In some cases where there has been no discernable reason for the IVF to have failed, a procedure called endometrial scratching has had some encouraging results.

How does an endometrial scratch work?

The procedure involves superficially injuring the womb lining thereby initiating a ‘repair reaction’ where the production of endometrial white blood cells is stimulated. This improves the implantation conditions of the uterus. Research is still to be carried out to understand how and to what extent endometrial scratching is successful, but the belief is that growth factors, hormones and chemicals are released during the repair process. The new lining appears to be more welcoming to an implanted embryo. The scratching may also ‘switch on’ the genes responsible for preparing the endometrium for implantation, thereby increasing the chances of a successful pregnancy.

Female gynaecologist Miss Amanda Tozer who offers the service at her London fertility clinic will be glad to talk about whether you would be a good candidate for endometrial scratching and to answer any questions you have on the treatment.

An endometrial scratch sounds painful – is it?

Endometrial scratching may cause some minor discomfort, similar to that of a cervical smear, but should not be painful. The scratch itself is made with a plastic catheter. It may be an idea to take some paracetamol half an hour before the procedure, but no anaesthetic is required and takes just 15–20 minutes. London-based Miss Tozer will talk you through what to expect during and after the procedure, explaining that afterwards you may experience some mild cramping and you may prefer to take the day off work rather than return immediately.