A very expensive scratch…?

After the biopsy, I was talking to the nurse and I asked whether endometrial scratching was similar. (For those that don’t know — and really, why should you? I certainly didn’t until I embarked on this “journey” — said ironically, OBVS. Also said ironically — an endometrial scratch is a procedure that appears to have some validity in improving IVF outcomes. It is, as it sounds, deliberately scratching the endometrium, or womb lining, which seems to cause an inflammatory response that leads the body to produce various chemicals which may make the endometrium more receptive to an embryo.

Although confusingly it doesn’t help everyone, in fact the data says that pregnancy and birth rates are higher when they did it to women who had 2 or more implantation failures but it didn’t seem to have a benefit if you did it before a first cycle, or following just 1 failed IVF cycle – weird, huh? No I dunno either.)

Anyway, she told me that endometrial scratching was an identical procedure “only we don’t keep the stuff we remove”. That “keeping the stuff” (oh, alright and analysing it with state of the art, cutting edge technology) is what makes this procedure six times the price of an endometrial scratch. I’m pretty sure that I mentioned it was an expensive test — and actually if you analysed my recent tot up line by line you’ll have seen it — but yes, £1200 at my clinic. (If it’s cheaper at yours, I don’t want to know, if it’s more expensive, I do.)

Anyway, as the cogs in my brain began to whirr, I couldn’t help but ask the nurse, “Ummm, is there any suggestion that improved outcomes after this test are a result of the fact that you’ve basically done an endometrial scratch…?” To which she responded, as you would. “Well if it comes back that the endometrium is receptive then maybe, yes. But if it comes back saying that the tissue is pre-receptive or post-receptive, we totally change the timings of the embryo transfer so while it might help, it does change the protocol.”

Also, I guess, if you have to put it in the day before or the day after you have to create the embryo and then freeze it, otherwise it would be under- or over-developed when you put it back, so I wonder whether that helps in some way too. There is some evidence that suggests that frozen embryo transfers are more successful than fresh (in fact some clinics are moving towards separating IVF cycles in two, harvesting the eggs and creating the embryos in one cycle and then freezing them and transferring them in another) — presumably because your body is not simultaneously trying to recover from the abuse that is egg retrieval, and a load of drugs, but also because one would imagine that freezing and defrosting weeds out the crappy embryos that were never going to take anyway…

I mean, maybe I just paid over the odds for an endometrial scratch (which currently costs £350 at my clinic), and maybe I didn’t. I guess I’ll have a better idea when I get the result…


2 thoughts on “A very expensive scratch…?

  1. The scratch didn’t work for me but I have heard lots of stories of women it helped get pregnant. I had the biopsy done recently too, in my case to test for something called, endometritis (https://academic.oup.com/humrep/article/30/2/323/726170/Prevalence-of-chronic-endometritis-in-repeated). The stuff you learn once you start going through IVF! Anyway, best of luck for your ERA test results and for your next transfer when you get to that stage again 🙂

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