Scratching the womb lining could double IVF pregnancy rates

Pregnancy rates from IVF could be doubled by gently scratching the womb lining with a plastic catheter, according to our doctors. 

In a review study published today, Monday 1 October, in Reproductive Biomedicine Online, the team found that this simple outpatient procedure could dramatically increase the chance of IVF success.

The procedure is endometrial scratching, which involves gently rubbing the womb lining for less than one minute. This is carried out in the clinic in the month before an IVF cycle is done, using a plastic catheter of the type normally used to collect specimens from the womb lining.

“Endometrial scratching uses simple, inexpensive equipment that most hospitals already have and which clinicians are already trained to use, so complications are rare,” said Dr Tarek El-Toukhy, who led the review study. The team analysed eight studies from various countries, which looked at 901 patients in total. The review showed that when endometrial scratching was carried out, pregnancy rates doubled.

Why?

It is thought that scratching the womb lining causes a repair reaction where growth factors and other chemicals are released. This may make the womb more likely to accept an embryo. Another explanation could be that endometrial scratching affects which genes are ‘switched on’ in the womb lining. More research is needed to understand exactly how this works.

“It’s exciting that the chance of pregnancy could be doubled,” said Dr El-Toukhy. “The next step is to see if this applies to birth rates. Around one third of IVF treatments results in a baby, so improving these odds would make a big difference to people trying to have children through IVF.”

Most IVF research focuses on the embryo rather than the womb. “We need to think about both,” said Dr El-Toukhy. “By making the womb more receptive to the embryo, the chances of pregnancy could be increased.” 

Next steps

The team at our assisted conception unit plan to conduct a clinical study to investigate if the birth rate is also increased by the same amount.