One in 10 couples have trouble conceiving a baby and that number grows all the time. Reasons are myriad. The cultural shift that has occurred with women waiting to conceive until their mid-thirties greatly decreases their chances of conception. Especially after age 35, chances of conceiving fall sharply. Another problem is fallopian tube damage from sexually transmitted disease. Experts say about one-third of the time the problem lies with the women, whether it is ovulatory or damaged fallopian tubes. One-third of the time it is a problem with the male, whether it is sperm numbers or motility, and another one-third of the time it’s both the male and female, or the cause is idiopathic, meaning no known reason for infertility has been found.
In a review of trials involving 1,000 women, infertility specialists discovered a trend, although it is far from being scientific enough to be considered a standard procedure – in women whose endometrium was scratched with a probe the approximate size of drinking straw one month prior to In Vitro Fertilization or Ovulation Induction, twice as many conceived as when the endometrium was not scratched. Nobody is sure exactly why, but one thing is known – the procedure hurts. Although it’s done in a doctor’s office, there’s little way to numb the area, and women reported an average pain score of six out of 10, according to Daily Mail.
Some theories on why this works is that scratching the endometrium causes inflammation and stages of healing, which may make it easier for a fertilized ovum, or zygote, to burrow into the endometrium in order to properly implant and begin to grow. The review of this procedure was considered low-quality, according to the European Society of Human Reproduction and Embryology in Helsinki, Finland, although the information certainly warrants more study and consideration by reproductive specialists.
As with any injury, purposeful or not, there are considerations of complications besides pain to consider. Bleeding or infection are likely the most common and potentially serious, but poking through the uterus with the probe is a risk as well. Although the procedure is low-cost and relatively easy to accomplish by the average reproductive specialist, these are issues that cannot be ignored. Professor Nick Macklon, of Southampton University, said the correlation between an injured endometrium and conception was quite accidental. Physicians began to notice a trend that women who had received an endometrial biopsy, which scratches and scrapes the endometrium, were becoming pregnant the next month. However, Macklon urges physicians to consider that there is not enough evidence yet to routinely offer this service, especially to women not going to undergo IVF.
“There’s no evidence of good enough quality to imply that couples setting out to conceive spontaneously should seek this treatment from their doctors.”
However, current research of good quality, with little room for bias, is currently being conducted to find out if this is a reliable and safe option for increasing chances of pregnancy. Through review of current charts, there has been no evidence to suggest that endometrial scratching increases the risk of miscarriage, ectopic pregnancy, premature birth or stillbirth. These correlations will be closely monitored in the current and future studies.
For many couples, any bit of good news in the infertility spectrum is something hopeful to hold on to. If endometrial scratching does indeed double the success rate of IVF, it would be a huge breakthrough in reproductive medicine.
[Photo by Layland Masuda/Getty Images]