Endometrial Scratching

Endometrial Scratching

A potential add-on to prepare the uterus for embryo implantation.

What is an Endometrial Scratch?

Embryo transfer is a vital stage of IVF treatment, sometimes, however, the embryo doesn’t implant and this can be because of a problem with the endometrium. An Endometrial Scratch is performed in an effort to improve the chances of implantation. 

HFEA, the Human Fertilisation & Embryology Authority, investigates treatment add-ons regularly and assigns them a level with a traffic light system. The traffic-light rated list of add-ons consists of three colours that indicate whether the evidence, in the form of high-quality RCTs, shows that a treatment add-on is effective at improving the chances of having a baby for someone undergoing fertility treatment.The HFEA rates the Endometrial Scratch as an AMBER add-on.

How much does an Endometrial Scratch cost?

An Endometrial Scratch costs £310 in addition to your standard treatment cost. The final cost of your treatment will depend on your individual circumstances.

When is it recommended and why?

A scratch is usually completed in the second half of the menstrual cycle immediately preceding your next  IVF cycle. We advise our patients to avoid unprotected intercourse in the cycle during which you intend to have the treatment.

Does an endometrial scratch improve the chance of having a baby?

We do not know for sure if this procedure increases the chance of having a baby. The theory is that the healing process following a scratch produces certain inflammatory chemicals and hormones.  The substances promote better development of the lining of the uterus and make the endometrium more receptive to an implanting embryo.

However, studies into the effect of endometrial scratch have not shown a clear benefit. In 2021, a meta-analysis was performed of eight studies into endometrial scratch. In this type of research, the results of all the studies are combined and analysed together. The results suggest that, if the chance of having a baby from IVF is usually about 27%, then the chance of having a baby when using endometrial scratch before IVF would be somewhere between, less than 27% and 32%.  This means that the research does not confirm that scratch is of benefit and it does not rule out that it may even harm your chances.

What does an endometrial scratch involve?

You will be asked to attend in the second half of your cycle. You may need an internal scan to assess the shape and position of the womb before the procedure.

You will have a speculum examination (similar to having a cervical smear) and a very thin plastic tube is passed through the cervix (neck of your womb) to reach the endometrium. The instrument is then moved up and down to take a sample of lining of the womb that will be shed by the period prior to treatment. A biopsy specimen may be sent for further histological examination (checking under the microscope), but this is not routinely carried out. If a histological examination is required on the sample you will incur a further cost which will be discussed with you prior to making an appointment for this procedure.

What should I expect during the procedure?

During the procedure a lower abdominal cramp (similar to period pain), may be felt. You may experience some light bleeding or some spotting for a few days after the procedure has been carried out.

What are the risks if I have an endometrial scratch?

Although the procedure is tolerated well, the procedure often causes some pain, which may require the use of painkillers such as Ibuprofen. You may wish to take some simple painkillers 30-40 minutes before the procedure.

You may experience some light bleeding or some spotting for a few days afterwards. There is a small risk of infection due to the procedure.

How can I book an appointment for an Endometrial Scratch?

Once you have had your consultation with our doctor, if an Endometrial Scratch is advised for you, a patient advisor can book your procedure between days 14 to 21 from your last menstrual period. 

You can contact our In Patient team to arrange this via the Salve app or by calling the clinic on 0161 300 2730.

What are add-ons?

At Manchester Fertility, we do charge for an Endrometrial Scratch.

Add-ons are optional extras that we offer in addition to your normal fertility treatment; these may incur an additional cost. Some clinics may include specific add-ons with their treatment packages, while others charge separately. This add-on is an optional extra and is not included as part of your standard treatment plan. It can be paid for as an additional part of your treatment.

Your doctor will be able to provide you with the complete information and risks associated with add-ons. We offer add-ons after a discussion with our experts and after your specific individual circumstances have been considered.