What is endometrial scratching?

In order to have a successful pregnancy, an embryo needs to ‘implant’ in the womb; if it doesn’t, the patient will need to start their cycle again.
Most embryos don’t implant because they’ve been unable to develop fully to the implantation stage or because of a developmental mismatch between the stage of the embryo and the lining of the womb.

Endo Scratch IVF

However, in a small number of cases an embryo won’t implant because the lining of the womb isn’t providing them with the right environment. Endometrial scratching, also known as endometrial injury, is carried out before IVF. During the procedure the lining of the womb (the endometrium) is ‘scratched’ using a small sterile plastic tube.

The endometrium is a layer of tissue that lines the inside of the womb. In the first step of a pregnancy, an embryo will attach to the endometrium in a process called implantation. Endometrial scratching, also known as endometrial injury, is a procedure undertaken to purposely disrupt the endometrium in women who want to get pregnant. It is thought this disruption may somehow increase the chance of an embryo implanting, creating a pregnancy. The theory is that this procedure triggers the body to repair the site of the scratch, releasing chemicals and hormones that make the womb lining more receptive to an embryo implanting. Some also suggest the treatment may activate genes that make the womb lining more receptive to an embryo implanting.

An endometrial scratch is a procedure carried out before IVF proposed to improve endometrial receptivity and increase the probability of pregnancy in women undergoing IVF by scratching the womb’s lining (the endometrium) using a small sterile plastic tube. It is generally only used for patients who have experienced multiple unsuccessful IVF cycles, despite the transfer of good quality embryos.

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Although this is an intrusive procedure, it is not common for patients to have an infection after the scratch. There is a small risk that if you have an infection within your cervix before ‘scratching’, this may cause the infection to spread into the uterus. Your clinic can treat this if necessary. Endometrial scratching does not carry any additional known risks for the child born due to fertility treatment.

Endometrial scratching is a simple, low-cost procedure that can be done at an outpatient appointment, without anaesthetic, in just a few minutes. It can cause some discomfort or pain and some bleeding. Risks of endometrial scratching include infection and uterine perforation, but these are very rare.