Want to Get Pregnant? Go Get a Scratch

It sounds bizarre (and painful), but doctors in Britain have found a way to double the chances that a woman will get pregnant through in-vitro fertilization (IVF) by simply scratching her endometrium.

According to bmj.com, "Endometrial scratching involves causing intentional damage to the endometrium through biopsy or curettage. An association between endometrial scratching and an increased chance of pregnancy was first described a decade ago, although the underlying mechanism remains unknown."

Katie Moisse reports at abcnews.com that the procedure, called local endometrial injury, takes about 15 minutes and costs as little as $200.  Women are locally anesthetized, then scraped quickly with a sharp instrument.  Doctors liken it to a Pap smear.

"Because the success rate of IVF is modest, these results are of considerable interest since the proposed intervention is neither expensive nor time-consuming and is apparently devoid of significant complications," Moisse quotes the review authors.

In IVF, a woman's eggs are plucked from her ovaries and fertilized in a laboratory. The resulting embryos are then transferred back into the woman's womb, but fewer than half will implant in the uterine lining and result in a pregnancy, according to the Society for Assisted Reproductive Technology, Moisse points out.

"It's a very complicated biochemical process," Dr. Richard Paulson, director of the Fertility Program at the University of Southern California's Keck School of Medicine in Los Angeles, told Moisse. "The embryo has to chemically communicate with the surface of the endometrium, give a kiss of death to some of the cells underneath to make room for implantation, and then invade the tissue much like a cancer."

As someone who has been through this numerous times, with one live baby to show for it, I'd jump at the chance.

But some remain skeptical of the small scratch that others say can make the womb more amenable to implanting an embryo and moving on to create a baby. 

The idea of scratching the womb to aid implantation stemmed from the observation in 2003 that women who had endometrial biopsies after one or more failed IVF cycles were more likely to get pregnant, Moisse notes. "But it's unclear how an endometrial injury might improve implantation. Some studies suggest the tiny scratch triggers the release of growth factors from the uterine lining. But the timing of it -- one month before a woman starts IVF -- raises questions," she writes.

"All those cells are going to be sloughed off," Paulson told her, explaining how the uterine lining sheds with each menstrual period. "That's a problem."

The procedure, Moisse quotes Paulson, also defies Mother Nature.  "Teleologically, this would never have occurred in nature," he told her, of injuring an organ to boost its function. "You might be allowing the implantation of an embryo that would not normally implant."

Is it worth the try?  Many think so.  The scratch can't harm you (and supposedly it's no more painful than a menstrual cramp) and if it can do some good, why not go for it? Since IVF can be such a crap shoot -- and a very expensive one at that -- this would seem to make a lot of sense, no?