‘Scratching’ may help women get pregnant

A clinical trail showed a dramatic increase in live births—from the current average of 23 percent to 42 percent—for women who underwent endometrial scratching as part of IVF and ICSI treatment. (Credit: Sandor Weisz/Flickr)

A one-time procedure appears to significantly improve chances of having a baby for women undergoing assisted reproductive treatment.

A recent clinical trial shows the procedure—called endometrial scratching—was linked to a dramatic increase in the clinical pregnancy rate of women undergoing IVF and ICSI treatment to 49 percent, compared with the current average of 29 percent.

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“This is the first well-designed trial conducted into endometrial scratching and the results are promising,” says study co-author Nick Raine-Fenning of the Nottingham University Research and Treatment Unit.

“Other trials have provided anecdotal evidence, but these have been limited and many questioned the validity of the technique. We are now carrying out a follow up study in Nottingham to provide further guidance into the use of endometrial scratching and early results are encouraging.”

Endometrial scratching, or injury, is defined as medically administered damage to the inner lining of the womb and was first demonstrated as a beneficial procedure in reproductive medicine in 2003.

However “scratching” is an intrusive procedure and many people are still unsure as to how it works or indeed if it definitely does work. Also, optimal timings and protocol for the intervention are not clearly defined.

About the study

All of the 158 women recruited for the clinical trial had previously received unsuccessful courses of reproductive treatment and were taking an oral contraceptive pill directly before the trial treatment commenced.

  • 77 of these women were randomized to and received the “scratching” intervention, which was administered 7 to 14 days before core reproductive treatment began, as part of standard pre-treatment gynecological screening.
  • 39 of the 77 women achieved clinical pregnancy and 33 cases resulted in live births, compared with 23 live births in the control group.

The results of the clinical trial, which were published in the journal Ultrasound in Obstetrics & Gynecology, also demonstrated that endometrial scratching had no effect on miscarriage or multiple pregnancy rates compared with standard protocols.

Despite the wide spread use of the technique, the mechanism behind the success of endometrial scratching remains unknown. The trial was conducted by Raine-Fenning in collaboration with colleagues at the University of Sao Paolo and the Ultrasonography and Retraining Medical School of Ribeiro Preto in Brazil.

Source: University of Nottingham