Endometrial scratch before IVF
The aim of endometrial scratching to help implantation. By carefully scratching the lining of your womb through the endometrial scratch, we can initiate a repair process that forms a new uterine lining.
What is endometrial scratching?
Could endometrial scratching be right for me?
What does an endometrial scratch involve?
Timing of endometrial scratch
Cost of an endometrial scratch
HFEA comment
Are there any risks?
There is a risk of infection with any transcervical procedure that may require treatment with antibiotics but this happens in fewer than 5% of cases The risk of perforation with any uterine instrument is ~1:500 so is uncommon. There is a small risk that if you have an infection within your cervix before ‘scratching’, this may cause the infection to spread up into the uterus. Your clinic can treat this if necessary.
ES can cause period like pain or cramping and/or a small amount of spotting or bleeding after the procedure but the discomfort should be manageable with over the counter pain relief. Around 1 in every 200 women having this type of procedure may feel faint afterwards but this is usually brief and we will make sure you are feeling well before you leave the clinic.
The independent regulator of fertility treatment, the Human Fertilisation and Embryology Authority (HFEA), has developed a ‘red-amber-green’ rating system and provides information on their website about treatments that are offered on top of your routine fertility treatment – known as treatment add-ons. They consider that the only way to be confident that a treatment is effective enough to be used routinely is to carry out a randomised controlled trial (RCT). In an RCT, patients are assigned randomly to two groups: a treatment group, given the new treatment and a control group, given a well-tried treatment or a placebo.
The HFEA has given ES an amber rating because the evidence for its effectiveness is based on a small number of moderate quality studies. The HFEA website notes that there are larger RCTs in progress but findings suggest that the benefits of ES may be less certain than initially thought.
What are the side effects of endometrial scratching?
There is a risk of infection with any transcervical procedure that may require treatment with antibiotics but this happens in fewer than 5% of cases The risk of perforation with any uterine instrument is ~1:500 so is uncommon. There is a small risk that if you have an infection within your cervix before ‘scratching’, this may cause the infection to spread up into the uterus. Your clinic can treat this if necessary.
ES can cause period like pain or cramping and/or a small amount of spotting or bleeding after the procedure but the discomfort should be manageable with over the counter pain relief. Around 1 in every 200 women having this type of procedure may feel faint afterwards but this is usually brief and we will make sure you are feeling well before you leave the clinic.
The independent regulator of fertility treatment, the Human Fertilisation and Embryology Authority (HFEA), has developed a ‘red-amber-green’ rating system and provides information on their website about treatments that are offered on top of your routine fertility treatment – known as treatment add-ons. They consider that the only way to be confident that a treatment is effective enough to be used routinely is to carry out a randomised controlled trial (RCT). In an RCT, patients are assigned randomly to two groups: a treatment group, given the new treatment and a control group, given a well-tried treatment or a placebo.
The HFEA has given ES an amber rating because the evidence for its effectiveness is based on a small number of moderate quality studies. The HFEA website notes that there are larger RCTs in progress but findings suggest that the benefits of ES may be less certain than initially thought.
What’s the evidence for endometrial scratching?
There is a risk of infection with any transcervical procedure that may require treatment with antibiotics but this happens in fewer than 5% of cases The risk of perforation with any uterine instrument is ~1:500 so is uncommon. There is a small risk that if you have an infection within your cervix before ‘scratching’, this may cause the infection to spread up into the uterus. Your clinic can treat this if necessary.
ES can cause period like pain or cramping and/or a small amount of spotting or bleeding after the procedure but the discomfort should be manageable with over the counter pain relief. Around 1 in every 200 women having this type of procedure may feel faint afterwards but this is usually brief and we will make sure you are feeling well before you leave the clinic.
The independent regulator of fertility treatment, the Human Fertilisation and Embryology Authority (HFEA), has developed a ‘red-amber-green’ rating system and provides information on their website about treatments that are offered on top of your routine fertility treatment – known as treatment add-ons. They consider that the only way to be confident that a treatment is effective enough to be used routinely is to carry out a randomised controlled trial (RCT). In an RCT, patients are assigned randomly to two groups: a treatment group, given the new treatment and a control group, given a well-tried treatment or a placebo.
The HFEA has given ES an amber rating because the evidence for its effectiveness is based on a small number of moderate quality studies. The HFEA website notes that there are larger RCTs in progress but findings suggest that the benefits of ES may be less certain than initially thought.