Fertility Treatment

Endometrial Biopsy & Uterine Scratch


An Endometrial Biopsy for Improved IVF Implantation

What is a Uterine Scratch

The Uterine Scratch is a very minimal “procedure,” where the physician “scratches,” or takes an endometrial biopsy of the uterine cavity just prior to the menstrual cycle. Most commonly this is done before a cycle in which the patient will undergo IVF, but also with other fertility treatments like IUI or medicated intercourse.

The procedure is often done for those who have failed a or numerous cycles however some people do indeed choose to have it done in preparation for their first IVF treatment cycle.

The procedure requires no anesthesia and takes only 5 minutes.  Due to the mild discomfort of the surgery, it may be suggested that you take Advil or Motrin approximately one hour before the procedure.

Theory Behind the Scratch

Why Do an Endometrial Biopsy Uterine Scratch Procedure

The theory behind doing the procedure we are “tilling the soil” and helping the endometrium (uterine lining) become more vibrant and implantation potential or an embryo.

Following controlled and intentional “damage” to the endometrial lining caused by the scratch procedure, chemicals called cytokines are released which promote healing of the “injury,” and brings in new healthy tissue.  This healing process also promotes what is called decidualization which encourages implantation by helping to slow the changes that are occurring in the endometrium.  This can help with implantation since the hormone levels associated with IVF can accelerate endometrial growth and therefore make the uterine lining out of synch with the actual embryo development.

A recent review of the five published studies on the effects of performing an endometrial biopsy prior to or during an IVF cycle found that four of these studies demonstrated that endometrial biopsy significantly improved implantation—suggesting that in some patients it may even double success rates.  In one study that involved performing the biopsy on the day of the egg retrieval, they found a dramatic reduction in the implantation and on-going pregnancy rate; an observation that validates our understanding that timing is critical to the procedure.

An Endometrial Scratch is often time performed with a Hysteroscopy and D & C.

Play Video
Uterine Scratch and Endometrial Biopsy - 2:37 min
Dr. Kiltz explains what you need to know about a uterine scratch and endometrial biopsy procedure.