When a patient or couple begins an IVF cycle, we are always hopeful that success will be achieved the very first cycle. Despite excellent pregnancy rates, some patients may require more than one cycle to achieve a healthy pregnancy. Most failed cycles occur because the embryo was genetically abnormal and not healthy enough to develop into a baby. Sometimes other factors play a role, too. For instance, if the uterine lining is not optimized, then it may be more difficult for an embryo to implant. Women who have had multiple failed IVF cycles, despite seemingly good quality embryos, may be candidates for what we call “endometrial scratching.” Endometrial scratching boosts pregnancy rates.
Studies suggest that, in women who have failed prior IVF cycles, endometrial scratching appears to improve the implantation rate of a subsequent cycle. Recent data suggests that endometrial scratching may also improve pregnancy rates for women who are undergoing IUI or trying to conceive on their own. A review of 8 different trials suggested that endometrial scratching may double pregnancy rates in infertile women trying to conceive.
Endometrial scratching typically involves performing an endometrial biopsy with a very small pipelle (tiny plastic tube) that is inserted through the cervix and into the uterus. A small sample of endometrial tissue is obtained. The mechanism behind endometrial scratching is not entirely understood, but we speculate that disrupting the lining of the uterus releases growth factors that help to improve embryo implantation.
We are very proud of our pregnancy rates at Fertility Centers of New England. For patients who have not had success with IVF at other centers, we are happy to provide a full review of your medical history and prior cycles. If you are interested in seeing if you would be a good candidate for endometrial scratching or have further questions about the best treatment path for you, please contact us today!
Potdar N, Gelbaya T, Nardo LG. Endometrial injury to overcome recurrent embryo implantation failure: a systematic review and meta-analysis. Reprod Biomed Online. 2012 Dec;25(6):561-71.
Lensen SF, Manders M, Nastri CO, Gibreel A, Martins WP, Templer GE, Farquhar C. Endometrial injury for pregnancy following sexual intercourse or intrauterine insemination. Cochrane Database Syst Rev. 2016 Jun 14;6:CD011424.