Caution urged over scratching womb to boost IVF odds

A new study has found that a simple scratch could increase your chances of having an IVF baby, but the researchers have urged caution over the findings, saying there is insufficient evidence to consider it for women.

The review of randomised controlled trials evaluating endometrial scratching in women planning to have intrauterine insemination (IUI) or attempting to conceive spontaneously (with or without ovulation induction) suggests that endometrial scratching may well be beneficial in couples trying to conceive naturally or with IUI, although “the quality of the available evidence is low.

Eight eligible trials with a total of 1180 women were included in the Cochrane review, in which endometrial scratching was compared to no intervention or a mock intervention. The primary outcomes were live birth/ongoing pregnancy and pain from the intervention.

Following analysis, endometrial scratching appeared to increase the chance of clinical pregnancy and live birth compared to no procedure or a placebo procedure; the difference in outcome was statistically significant and appeared to roughly double the chance of live birth compared to no intervention.

Researcher Sarah Lensen from the University of Auckland explained that endometrial scratching would increase the normal chance of a live birth or ongoing pregnancy from 9% over a set period of time to somewhere betweem 14 and 28 %.

However, the quality of the studies from which the result was derived was described as “very low-quality”. “The results must be treated with caution,” said Lensen, as most of the included trials were associated with a serious risk of bias. There was no evidence that endometrial scratching has any effect on miscarriage, ectopic pregnancy or multiple pregnancy. Pain during the scratch procedure was reported by one study as an average of 6/10.

Lensen described endometrial scratching as “a cheap and simple procedure” which can be conducted without analgesia during a short clinic visit; it does, however, require an internal examination which is associated with pain and discomfort.

The study is presented at the 32nd Annual Meeting of the European Society of Human Reproduction and Embryology.