Endometrial Scratching – For uterine rejuvenation
What is endometrial scratching or Coring ?
Endometrial scratching / Coring are synonyms to the procedure of causing endometrial injury in an aseptic and controlled manner in a woman planning to undergo an ART cycle.
Who needs endometrial scratching ?
Its indicated in women with failed previous IVF cycles in whom implantation failed to occur despite good quality of embryos.
When and how is it performed ?
Endometrial scratching is usually performed in the early follicular phase of the menstrual cycle in which IVF is planned.
A thin ,plastic,flexible tube called Pipelle’s catheter which is narrow enough to pass through a woman’s cervix without dilatation is used to create an endometrial injury by means of rotational movements within the uterus, similar to how an endometrial biopsy sampling is done.
Since there is no need to dilate the cervix, anaesthesia is not required. Mild analgesics are enough to tide through the minimal pain and discomfort. It is done on an outpatient basis and the lady can go home within few hours.
How does it work ?
Endometrial scratching is basically an aseptic injury to the inner lining of the uterus. The repair mechanism that sets in following the injury involves the release of biochemicals that favour implantation of embryo. Hence when this is performed in the early follicular phase of IVF cycle, the uterine inner lining is rejuvenated towards accepting the incoming embryo.
Evidence Based Medicine !
Cochrane Review, the most famous and trusted among scientific reviews, has analysed data on endometrial scratching and has concluded that endometrial scratching performed in the IVF cycle improves the clinical pregnancy rate and live birth rate. If 26% of women achieve pregnancy without this intervention, Cochrane review found that 28-48% of women will get pregnant following this step. Also, there is no evidence of side effects such as bleeding or miscarriages attributed to this intervention, during the subsequent pregnancy.
Dr. Arya Rajendran & Dr. Deepika K – Milann