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Endometrial scratching offered by 1/3 of IVF clinics

20 December 2021
Appeared in BioNews 1126

Endometrial scratching is currently being offered by 34 percent of IVF clinics in the UK, Australia, and New Zealand, according to a latest survey.

The procedure is performed as an add-on to standard IVF treatments and involves the use of a catheter to intentionally scratch the endometrium to cause an inflammatory response. Researchers at Monash University in Melbourne, Australia, anonymously asked 121 fertility specialists, embryologists, and fertility nurses whether their clinic performed the procedure and whether they thought it was beneficial. Their results, published in Human Fertility, found that less than 10 percent believed it improved pregnancy outcomes but that it was being offered by 34 percent of clinics.

The topic has attracted a great deal of debate due to uncertainty regarding how endometrial scratching works and whether it increases the chances of live birth. Dr Sarah Lensen from the University of Melbourne, Australia, and one of the authors of the study told Inverse, 'We don't have good evidence that endometrial scratching helps people to have a baby from IVF, and it's a painful procedure associated with a cost for the patient too'.

In the same survey, 29 percent of fertility specialists believed that endometrial scratching could be advantageous in women struggling specifically with recurrent implantation failure. Dr Lensen appreciates that this might be driving the continued use of endometrial scratching in clinics.

Of those asked, 55 percent believe that endometrial scratching offers a reduction in psychological distress. Dr Lensen's understanding is that 'these extra treatments help to keep the hope alive and help patients to feel more in control in a very uncertain time'.

Attitudes towards the procedure have shifted over the last five years; a previous study by Dr Lensen, published in Human Reproduction in 2016, found that 83 percent of professionals within the fertility sector recommended endometrial scratching. Analysis from the follow-up survey showed that 51 percent of clinics that previously offered endometrial scratching, no longer do.

Dr Lensen believes the disparity can be attributed to a greater number of high-quality studies being published. The team are encouraged by the decline in the number of clinics offering endometrial scratching, proving that providers are listening to the research and acting to take patient's wellbeing into account.

Globally, 48 million couples are affected by infertility. With add-ons, such as endometrial scratching, becoming increasingly popular, the Australian team will continue their research with an aim to provide resources to patients to aid them in making informed decisions about their care.


Dr Sarah Lensen will be discussing fertility treatment add-ons at the Progress Educational Trust's free-to-attend online event 'Adding Up What We Know: A Global Perspective on Fertility Treatment Add-Ons', from 5.30pm-7.30pm (GMT) on Wednesday 26 January 2022. Register here.

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