Endometrial scratching is a technique used to improve the ability of an embryo to implant in the uterus after in-vitro fertilization.
The endometrial scratching technique is a procedure proposed to improve endometrial receptivity and increase the probability of pregnancy in women undergoing IVF. It is generally only used for patients who have experienced multiple unsuccessful IVF cycles, despite the transfer of good quality embryos.
How Does Endometrial Scratching Work
The endometrium is the layer of tissue that lines the inside of the womb. In order for a woman to fall pregnant, an embryo must attach to this lining (termed implantation), so the implantation failure is considered to be the primary factor influencing human fertility and is usually attributed to a lack of uterine receptivity.
Endometrial scratching causes a regenerative process, which increases the implantation rates of the fetus. This technique activates the following two mechanisms:
During the regeneration process, growth factors, hormones, and chemicals are released. The new part of the endometrium that develops after the procedure is considered more receptive to the fetus, which increases the chances of pregnancy.
Genes are activated during this technique: Scientists believe that the genes responsible for implanting embryos are sometimes “inactivated”. Endometrial injury is thought to activate these genes, increasing the chances of pregnancy.
Which women can benefit from the technique
Most women have more than 2 implant failures (negative pregnancy tests) despite good quality embryo transfer.
How the process is performed
Endometrial scratching can be done in several ways:
1. During a hysteroscopy. This is the best method because the endometrium is checked with the camera at the same time.
2. With a slight scratch.
3. With a special catheter (pipelle).
How painful is endometrial scratching
This technique is not painful and does not require any preparation of the woman beforehand, as no anesthesia is used. The “scratching” of the endometrium is likely to cause discomfort and some mild pain.
The best time to do it
This technique is scheduled to be done in the cycle just before treatment begins. It should be done in the luteal phase of the cycle, after ovulation. In a 28-day cycle, you ideally suggest taking place on the 21st day of the cycle.
Which are the success rates
For all new techniques, several studies need to be performed to confirm their absolute success. According to research, endometrial scratching hysteroscopy favors couples who have a history of a failed implant but seem to be even more helpful when there are 2 or 3 implant failures (and while the embryos that have been transferred were of good quality). Some research studies,(which were published in the scientific journal Reproductive Biomedicine), confirm that in a total sample of two thousand women who applied the above technique, there was an increase in positive results of 70%. The technique of endometrial Scratching is minimally invasive and is applied before the drug protocol of the treatment of in vitro fertilization.