Endometrial scratching to improve implantation?
Endometrial scratching has limited evidence of efficacy
Endometrial scratching was first described in 2003 as treatment for suspected implantation failure by Israeli investigators (Barash et al., Fertil Steril 2203;79:1317-1322). The procedure has remained controversial ever since, though its utilization has increased worldwide. Dekel et al in 2010 offered evidence that endometrial injury in the preceding luteal phase may induce inflammatory processes in endometrium which in the subsequent cycle may improve implantation chances [Dekel et al., Am J Reprod Immunol 2010;63(1):17-21].
Because the diagnosis of implantation failure is always highly uncertain, one cannot be surprised that studies of endometrial scratching have shown inconsistent results. The honest truth is that, still, nobody knows whether endometrial scratching indeed improves implantation chances. CHR uses this procedure, therefore, sparingly, and only as a last resort.
This is a part of the September 2018 CHR VOICE.
Norbert Gleicher, MD, leads CHR’s clinical and research efforts as Medical Director and Chief Scientist. A world-renowned specialist in reproductive endocrinology, Dr. Gleicher has published hundreds of peer-reviewed papers and lectured globally while keeping an active clinical career focused on ovarian aging, immunological issues and other difficult cases of infertility.
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