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Womb scratching could improve IVF birth rate

14 October 2013
Appeared in BioNews 726

A procedure that uses a biopsy tool called a pipelle to 'scratch' the endometrial lining has been found to increase the chance of pregnancy and live birth as a result of IVF.

Endometrial scratching, or injury, involves inserting a pipelle through the cervix and lightly scraping it against the womb lining. When performed seven to 14 days before reproductive treatment, scientists showed that it increased the odds of an embryo attaching to the lining of the womb.

In a study on 158 women conducted at the University of Sao Paulo, Brazil, 77 women were given the scratch procedure before reproductive treatment began. Thirty-nine of these women became pregnant and this led to 33 live births, compared to 23 pregnancies and 18 births in the control group.

'We put a little device through the neck of the womb, a bit like having a smear, and take a sample', Dr Nick Raine-Fenning from the University of Nottingham, who conducted the study, told CBS News.

The procedure is straightforward, costs around £100 and can be conducted using readily available equipment in 15 minutes. However, it was found to cause 'considerable pain', with women reporting an average pain score of 6.4 on a scale of one to ten.

It is not fully understood how this technique works but one theory is that damage to the endometrial lining forces the uterus to 'sort of regenerate and fix itself', Dr Raine-Fenning told CBS News.

The study also found that endometrial scratching had no effect on miscarriage or multiple pregnancy rates compared to the control group. The study participants had all undergone previous unsuccessful reproductive treatment and were taking oral contraceptive pills prior to starting hormone treatment for IVF.

'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', said Dr Raine-Fenning.

Endometrial scratching boosts IVF odds by 20 percent, says study
CBS News |  9 September 2013
Endometrial scratching performed in the non-transfer cycle and outcome of assisted reproduction: a randomized controlled trial
Ultrasound in Obstetrics & Gynecology |  2 September 2013
IVF procedure can increase clinical pregnancy by 20 per cent
University of Nottingham |  7 October 2013
Scientists find simple 'scratch' technique improves IVF treatment success
Daily Telegraph |  6 October 2013
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