Researchers from the University of Melbourne conducted a study aimed at weighing the benefits and downsides of this procedure.
Almost all respondents agreed that pain or discomfort is a major disadvantage of the procedure, while more than half (50 percent) of the study participants viewed the cost, inconvenience and adverse effects as further issues.
Another key finding of the new study is that over a half (55 percent) of the respondents suggested that the procedure is only offered to patients for psychological reasons, rather than medical.
Most women wishing to have children are usually able to conceive naturally, get pregnant and give birth to healthy babies.
But there are others who struggle with these processes and eventually resort to a type of assisted reproduction technology known as In Vitro Fertilisation (IVF).
This is a type of infertility treatment in which a man's sperms and a woman's eggs are combined outside of the body in a laboratory dish.
Once fertilisation occurs, the ensuing embryo is transferred to or implanted in the woman's uterus where it is supposed to mature into a healthy baby that will be delivered after nine months.
The implantation can be a success for some women and a bit problematic for others who experience repeated failures, making it impossible for them to become pregnant.
To address this challenge, some fertility specialists or clinics have been relying on a procedure known as endometrial scratching (scratching the womb).
This refers to a technique in which a small scratch or tissue biopsy is made in the lining of the uterus prior to IVF. The rationale behind it is that the injury to the lining of the uterus may somehow increase the chance of an embryo implantation happening, thus leading to pregnancy.
In spite of these perceived benefits, the procedure comes with unwanted side effects including pain, discomfort and additional costs.
Against this backdrop, researchers from the University of Melbourne conducted a study aimed at weighing the benefits and downsides of this procedure.
The results showed that there was a marked decline in the number of specialists that recommended or performed endometrial scratching.
According to the researchers, the findings of this study contributes to the growing number of research papers that have cast doubt on the effectiveness of the procedure whose effect is questionable as there are no sufficient studies to ‘vouche’ for its impact.
The new study, which has been published in the Human Fertility Journal, anonymously conducted an online survey targeting 121 embryologists, fertility specialists and fertility nurses between October and December 2020.
The study participants – drawn from Australia (67 percent), the UK (25 percent) and, New Zealand (8 percent) - were asked about their views on the benefits of the procedure; their clinic’s policies or stance; as well as their thoughts on the advantages and disadvantages of endometrial scratching.
According to the results of the study, only a few of the participants noted that they actually believed endometrial scratching could improve pregnancy and live birth rates during the first round of IVF or thereafter.
In addition, almost all respondents agreed that pain or discomfort is a major disadvantage of the procedure, while more than half (50 percent) of the study participants viewed the cost, inconvenience and adverse effects as further issues.
“The use of endometrial scratching appears to have reduced over time, probably following recent publications of studies which do not report that the procedure improves the chance of having a baby. This is an encouraging finding, as it’s clear that many IVF providers do respond to new evidence as it emerges,” stated Dr Sarah Lensen, the lead author of the study from the University of Melbourne, Australia.
Another key finding of the new study is that over a half (55 percent) of the respondents suggested that the procedure is only offered to patients for psychological reasons, rather than medical as it is often a ‘last resort’ treatment option for those who have failed with several rounds of IVF.
“Many participants felt that endometrial scratching reduces distress among women who request it and offers hope to women who have had unsuccessful treatments. However, more research will be needed to clarify whether this does have psychological benefits for patients,” stated Dr Lensen.
Since this new study involved only a few participants and was restricted to three countries, the authors note that much more research is required before these findings can be generalised to all fertility care providers.
Nevertheless, they note that it offers useful information that can guide the decision-making process of both doctors and patients on whether to embrace or shun endometrial scratching.
Some of the natural approaches that can contribute to the success of embryo implantation include the intake of balanced diets with lots of fruits, vegetables, fibre, protein and complex carbohydrates.
It is also recommended that women stay hydrated throughout the IVF process, and especially in the early stages of implantation and pregnancy. This can be achieved by drinking plenty of water - at least two litres daily.
During the sensitive two-week wait between embryo transfer and a pregnancy test (to determine the success or failure of the procedure), health experts note that it is advisable to avoid strenuous activity.
Since excessive stress can have adverse effects on fertility, women are urged to try and relax in whatever way suits them. This can be achieved through yoga, meditation, walking and mindfulness techniques.
But activities such as hot baths, saunas and steam rooms which can significantly raise their core temperatures are not recommended.
Above all, doctors note that adherence to any medication recommended throughout the IVF treatment process is extremely important for enhanced implantation success rates.
If all these approaches fail, affected women can consider using a surrogate – another woman - to carry the embryo or pregnancy to term on their behalf. Upon delivery, child is usually handed over to the rightful parents – mother and father.
