What is endometrial scratching?
Endometrial scratching is an outpatient procedure, which is relatively painless (i.e. comparable to a cervical smear test). The procedure involves ‘scratching’ the endometrial lining of the womb with a very small catheter (plastic tube) prior to an attempt to get pregnant.
How does the procedure help with implantation?
An embryo must successfully attach itself to the wall of the womb for pregnancy to begin. Embryo implantation into the womb may fail due to poor embryo quality or abnormal embryo genetics. It can also often fail due to poor ‘endometrial receptivity’. This is where the lining of the womb is not favourable for the embryo to implant. The idea behind endometrial scratching it is that it causes a reaction in the endometrium with the release of certain inflammatory substances, which make the endometrium more receptive to an implanting embryo.
Recent studies have suggested that the endometrial scratch may improve implantation rates in patients who have had multiple failed IVF cycles despite good quality embryos, with significantly higher implantation, pregnancy and, most importantly, live birth rates following the technique.
A Cochrane review, (considered to be the highest level of research by the medical profession), published in 2012, summarised the currently available evidence on the subject and suggested that the procedure doubled the chances of pregnancy and live birth after IVF treatment. The review, which was led by Mr Raine-Fenning, did stress that evidence of benefit was restricted to women who had undergone previous, unsuccessful IVF or ICSI cycles and that more work was required.
Endometrial Scratching is available at Newlife for those patients for whom it is clinically recommended.
Time Lapse Photo Imaging
The correct selection of embryos for transfer is critical to the success of IVF and at Newlife Clinic we use the very latest monitoring technology to ensure that our patients’ embryos develop in optimum conditions.
Embryos are selected for transfer primarily based on the rate at which they develop from one embryonic stage to the next. Traditionally, embryos are observed over a one to five day period by repeatedly removing them from the incubator and noting development. The embryos that appear the best are then selected for transfer on day three two to five. However removing embryos from the stable environment of the incubator can cause ‘stress’ to the embryos.
The time lapse photo imaging system we use at Newlife provides the opportunity to observe all embryos with much greater frequency, but without disturbing them or exposing them to outside air conditions. The system constantly records what happens inside the incubator, enabling the embryologist to assess the embryo development objectively, without removing them from the incubator.
This allows them to make a far better informed choice when selecting the best quality embryos for transfer. Early studies have shown an improvement in the chance of live birth by 56% over conventional methods of embryo selection.
At Newlife, in addition to stringent manual checks, we use a state of the art laboratory monitoring system called RI Witness™ to make absolutely sure there is no chance of patients or embryos being confused by our embryologists.
RI Witness™ utilises RFID (Radio Frequency Identification) technology to track and record patient samples at each step of the IVF process, as an essential safeguard for laboratory staff and a reassurance for patients. With RFID Technology, every patient’s tracking ID is totally unique and cannot be misread.
The RI Witness™ system monitors every instance when gametes or embryos are transferred from one container to the next and ensures that only one patient can be worked on at any one time, safeguarding sample identity. If at any time, samples from incompatible patients are introduced into the same work area, RI Witness™ warns the laboratory personnel both visually and audibly.
Monitoring is constant, so an identity check can never be overlooked.