Is an endometrial scratch an effective add-on?

News out of the European Society of Human Reproduction and Embryology (ESHRE) has revealed that the endometrial scratch is largely ineffective.

A large randomised trial of over 1000 women was recently performed, women receiving the additional treatment finding it to be no more successful than those who received routine treatment.

An endometrial scratch is an add-on procedure that is offered at many clinics, where the ling of the uterus is “injured” or “scratched” in the hope of improving embryo implantation.

The theory behind endometrial scratching is that by “injuring” the lining of the uterus, the repair process will release growth factors, which will help increase the amount of receptivity to an implanting embryo and therefore increasing the chances of a pregnancy.

The study, which came out of the University of Sheffield in the UK, revealed that endometrial scratch treatments did not improve the chances of implantation. Women who received the add-on treatment had a live birth rate of 38.6%, whereas the patients receiving routine treatment had a live birth rate of 37.1%, with no statistical significance. The University observed other outcomes such as pregnancy and obstetric complications and implantation rates, however they found there was no significant difference between the two groups.

Previous studies have cast doubt on the effectiveness of endometrial scratching, however, the population of the studies were significantly smaller. Due to the size and design of this recent study, researchers have now been able to clarify just how effective this add-on is for patients around the world. Head researcher, Dr Mostafa Metwally from Sheffield Teaching Hospitals stated that “our study is the largest and most conclusive study in women having first time IVF treatment” and that “the findings conclusively indicate that the practice of performing scratch in this group should stop”.