Could a ‘cheap and simple’ procedure that scratches the womb double odds of having a baby for women undergoing IVF treatment?

July 4, 2016

‘Endometrial scratch’ technique uses a probe the width of a drinking straw
Eight trials found it helped odds of conception for women undergoing IVF
Debate whether technique is effective, as it’s not known how it might work
It worked for IVF patients, but not enough evidence for natural conception

Colin Fernandez for the Daily Mail

Published:
16:43 EST, 3 July 2016

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Updated:
16:43 EST, 3 July 2016

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A simple scratch to the inside of the womb could double a woman’s chances of becoming pregnant, research suggests.

A review of eight trials found the ‘cheap and simple’ procedure, which uses a probe the width of a drinking straw, improved the odds of having a baby for women undergoing IVF treatment.

The ‘endometrial scratch’ technique has been around for some time – but there is much debate among experts about whether it is effective as it is not yet known how it might work.

A review of eight trials found the ‘endometrial scratch’ procedure improved the odds of having a baby for women undergoing IVF treatment

Theories include that as the womb tissue repairs itself after it is scratched, hormones are released and the new lining that grows is more receptive to an embryo.

The review of trials involving more than 1,000 women added more weight to arguments that the method can improve the odds of becoming pregnant.

But experts urged caution, pointing out that while the study found the scratch seemed to work for IVF patients, there is still insufficient evidence to recommend it for couples trying to conceive naturally.

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They also stressed that scratching the inside of the womb can cause significant discomfort. In one of the reviewed studies, patients gave the procedure an average pain score of six out of ten.

The review, which was presented at the annual meeting of the European Society of Human Reproduction and Embryology in Helsinki, Finland, was conducted by researchers from Cochrane, a global organisation that assesses medical evidence to inform policy makers.

It found that the endometrial scratch – which is a similar process to taking a biopsy – roughly doubled the chance of a woman giving birth successfully compared to when no intervention was taken – from around 9 per cent to between 14 per cent and 28 per cent.

Experts urged caution, pointing out that while the study found the scratch seemed to work for IVF patients, there is still insufficient evidence to recommend it for couples trying to conceive naturally

However Sarah Lensen, of the University of Auckland in New Zealand, who led the review, pointed out that the evidence she and her team looked at was not of a high standard, adding: ‘The results must be treated with caution.’

The procedure is already offered in the UK in some private fertility centres to women for whom IVF has previously failed, at a cost of around £300. Trials are now under way to investigate whether it should be more widely recommended.

But British experts said despite its increasing popularity, the jury is still out on whether the endometrial scratch should be recommended, and in what situations.

Obstetrician Nick Macklon, of Southampton University, who is director of the city’s Complete Fertility Centre, said: ‘There’s no evidence of good enough quality to imply that couples setting out to conceive spontaneously should seek this treatment from their doctors.’

Professor Macklon said the initial discovery that the endometrial scratch might work was purely by chance. Scientists in Israel doing a study on womb cells were taking biopsies from women, and ‘someone noticed those patients having these biopsies all seemed to conceive in the next cycle’.

He added: ‘It was from there that the interest in this potential technique developed but we are still uncertain as to if it works and the mechanism is still open for debate.’

British Fertility Society chairman Adam Balen, a professor of reproductive medicine and surgery at Leeds Teaching Hospitals, said: ‘We’re certainly not suggesting that women who want to conceive should go out and have this procedure.’

Sarah Lensen, of the University of Auckland in New Zealand (pictured), who led the review, pointed out that the evidence she and her team looked at was not of a high standard