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Endometrial Scratch
What is Endometrial Scratching?
An endometrial scratch is a procedure which is performed to help embryos implant and increases the chances pregnancy. Research has shown that scratching the uterine lining causes a ‘repair reaction’ which may increase embryo implantation rates. The repair process releases growth factors, hormones and chemicals. The new lining which grows after the procedure is thought to be more receptive to an implanting embryo and so increases the chances of pregnancy. It is possible that genes which are responsible for implantation of embryos are sometimes not ‘switched on’ during the time when embryos are supposed to implant. Endometrial scratching may ‘switch on’ the genes that are responsible for preparation of the endometrium for implantation, which increases the chances of pregnancy. More research is being undertaken to understand the exact reasons why this happens.
Frequently Asked Questions:
Endometrial scratch may be recommended for women who have not achieved a pregnancy after several attempts of embryo transfer, despite the transfer of good quality embryos and the absence of other causes of failed implantation. The technique was used for patients who have had a failed assisted conception treatment cycles, but there is now emerging evidence that it may be useful in all treatment cycles, including patients having treatment for the first time.
It is usual for an endometrial scratch to be performed around day 21 during the cycle before your treatment commences.
New research and evidence suggest that scratching the uterine lining causes a ‘repair reaction’ which may increase embryo implantation rates:
The repair process releases growth factors, hormones and chemicals. The new lining which grows after the procedure is thought to be more receptive to an implanting embryo and so increases the chances of pregnancy.
‘Gene switching’ - scientists believe that the genes which are responsible for implantation of embryos are sometimes not ‘switched on’ during the time when embryos are supposed to implant. Endometrial scratching may ‘switch on’ the genes that are responsible for preparation of the endometrium for implantation, which increases the chances of pregnancy. Research is still being gathered to understand exactly how this works.
You must not have unprotected intercourse in the four weeks before the planned endometrial scratch appointment. You should use a condom for contraception during the cycle of the scratch appointment to avoid the risk of a possible pregnancy. Your clinic will advise you of the day that you will need your endometrial scratch which is usually around 7 – 9 days before your period is due.
You may eat and drink normally before the procedure. You do not need to empty your bladder before the procedure unless you feel uncomfortable with a full bladder. You should wear comfortable clothing that gives easy access to the lower part of your body. You should bring a sanitary towel with you for use after the procedure.
We recommend taking Paracetamol or similar mild analgesic half an hour before your appointment; this may help relieve any discomfort during the procedure.
A speculum is inserted into the vagina, the same as when having a smear test or embryo transfer. A very fine tube is passed into the cervical canal and into the uterus. The tube is then gently moved to ‘scratch’ the endometrium (lining of the womb). The procedure should only take 15-20 minutes. You may experience a little discomfort but no anaesthetic is required. The doctor or nurse performing the procedure will explain what is going to happen and then you will be asked to sign a consent form. A fine, thin plastic tube (flexible catheter) will then be passed through the opening of the cervix into the cavity of the uterus to gently and superficially scratch the lining of the uterus. (Inserting and moving the catheter up and down may cause mild abdominal cramping similar to period pain). Some mild bleeding is common after the procedure.
After the procedure you will be able to continue your normal daily activities, but you may benefit from not going back to work the same day. You can eat and drink normally immediately after. We recommend that you make arrangements for a relative or a friend to drive you home in case you experience more discomfort than usual during or after the procedure.
Endometrial scratch is a very safe procedure which does not require any anaesthetic. It is usual to experience some cramping pains during and after the procedure, but these will ease in a very short time. We will ensure you feel well before you leave the clinic. Very rarely, the procedure can cause pelvic infection. There is a very small risk that any infection within the cervix may spread to the uterine cavity during the procedure. This would become apparent up to 10 days following the procedure. If you suspect and experience any of the following signs and symptoms within a few days of the procedure, please contact your GP and inform them that you have had an endometrial scratch (biopsy):
Foul-smelling vaginal discharge.
Persistent bleeding.
Increasing lower abdominal pain.
Unexplained fever.
Feeling generally unwell.
We recommend that you take Paracetamol before the Endometrial Scratch and if you do experience any discomfort later in the day it is advisable to take a further dose after four hours. It is common to experience period type pains which may last for a few hours following the procedure.
Service Pricing:
Monday - Friday: £200.00
Please note: There is a £50 non-refundable deposit to be paid at the time of booking and £150 on the day of the procedure. Please be aware the deposit is not transferable and is only valid for use within 6 months of purchase.