One of the key factors towards that success is embryo implantation, which is a complex process.
In order to increase the probability of implantation a relatively new process called endometrial scratch and saline hysterogram is offered to our patients undergoing IVF/ICSI treatment.
The lining of the uterus (the endometrium) is gently ͚scratched͛ using a thin catheter, which is passed through the cervix. At the same time, the uterine cavity is rinsed with normal saline.
Recent research suggests that locally injuring the endometrium (i.e. scratching the uterine lining) causes the uterus to start a’repair reaction’, which may increase the chances of embryo implantation:
The endometrial scratch is a relatively new procedure and further research is being performed to understand the exact process by which it works.
The saline wash is performed in order to remove any debris from the surface of the endometrium and provide a clean surface for embryo implantation.
The best time to have the endometrial scratch is 7 to 10 days before the period starts. This is for a standard 28 day cycle, if your periods are infrequent or irregular, your doctor will advise on the best time for the procedure.
It is critical that this procedure is not performed during a pregnancy, therefore patients should not have unprotected intercourse in the four weeks prior to this procedure to avoid the risk of a possible pregnancy.
To prevent the risk of spreading any infection, all patients must be screened for Chlamydia and Gonorrhoea prior to the procedure.
We advise that you take over the counter pain relief 30 minutes prior to the procedure. We recommend Ibuprofen (400 mg) and Buscopan (10 mg). If you are allergic to Ibuprofen another option is Paracetamol (1 gram).
A prophylactic course of antibiotic will be prescribed: 1gm of Azithromycin (250mg x 4) orally and 1gm Flagyl suppository rectally the morning of the procedure.
Patients may eat and drink normally before the procedure. Patients are advised to drink 2 glasses of water 30 minutes before the procedure to ensure a half full bladder.
The endometrial scratch and saline hysterogram are not painful and although you may experience some discomfort, no anaesthesia is usually required. The procedure is similar to an embryo transfer and takes approximately 30 minutes. You will be able to resume normal daily activities after the procedure.
There is a small risk that any infection in the cervix may be spread to the uterine cavity. You should contact the clinic immediately if you experience any of the following symptoms within a few days of the procedure:
The endometrial scratch and saline hysterogram is an additional chargeable service and is not included as part of any treatment cycle such as IVF or ICSI. Please refer to a current price list for the exact charge.
You should wear a sanitary towel after the procedure because there may be persistent vaginal discharge for a few hours as the fluid used in the saline scan drains out of the vagina. This discharge is sometimes blood stained so do not become alarmed if this occurs. You should be able to resume normal daily activities after the procedure.
Endometrial scratch and saline hysterogram is an adjunct treatment and is not recommended for all patients. Please speak to your consultant about whether it might be beneficial for you.
Please refer to the regulator’s web page regarding treatment “add-ons” for further information: HFEA