Author Name: Dr. Monika Gupta Mentor Name: Dr. Aarifa Aadil on April 08, 2020

Endometrial scratching in failed IVF Cycles

Whenever a couple undergoes an IVF cycle, we expect IVF success in the very first IVF cycle. Despite of our high success rates, some patients might more than one cycle multiple cycles to achieve a successful pregnancy. In most of the failed cycles, embryos plays a very important role, be it genetically abnormal embryos or poor grading of embryos(quality). Other factors also plays a role like suboptimal endometrial thickness. Despite of transferring good quality embryos, IVF cycle fails. Several studies had been performed for medical approaches to improve the endometrial receptivity, one such procedure is endometrial scratching.

What is endometrial scratching?

It is a procedure which increases the endometrial receptivity and increases the chances of success of pregnancy in patients undergoing IVF. Endometrial scratching also called as an endometrial injury is a procedure to purposefully disrupting the endometrium. It is usually done in patients who had multiple failed IVF cycles despite of transferring good quality embryos. It is believed that disrupting the endometrium may somehow increase the chances of implantation.

When should endometrial scratching be performed?

Endometrial scratching is usually performed around day 21 of the menstrual cycle i.e.luteal phase of menstrual cycle. This roughly corresponds to one week after ovulation or one week prior to next expected periods. It should be noted that couple doesn’t have unprotected intercourse during this cycle as this procedure may damage the existing pregnancy.

How is endometrial scratching performed?

Endometrial scratching can be done with different types of instruments. The most common one is the endometrial biopsy procedure, normally done with a thin flexible plastic tube, a pipelle catheter. The pipelle is inserted through the cervix into the uterus, where it is moved up and down, rotated in order to cause some disruption. It is a simple and affordable procedure which can be performed in an outpatient department. It doesnt need any kind of anesthesia, can be performed in very less time. It might cause some discomfort or pain. Risks included with endometrial scratching are infection and uterine perforation, but these are very rare.

How does endometrial scratching works?

Several mechanisms have been proposed:

1. A local scratch in the endometrium might induce decidualization which in turn increases its receptivity to the embryo.
2. It might release cytokines and growth factors that provoke wound healing, which is beneficial for implantation; and
3. It might help in endometrial maturation.

We are proud to share that success rates at Indira IVF is around 70-75%. For patients who had previous failures at other centers, we are happy to review your medical history and previous IVF records. We would be happy to help you in the journey of motherhood

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