Fertility Specialists Still Recommend a Type of Painful IVF Treatment

The survey conducted in the UK, Australia, and New Zealand suggests add-on treatment of endometrial scratching might be offered for psychological reasons.

Despite a lack of evidence that the intrusive In vitro fertilization (IVF) treatment process of scratching the womb (endometrial scratching) increases the chances of having a baby, a third of fertility specialists are still offering this often-painful procedure.

Assisted conception methods are available to help these couples get pregnant, including medication to assist with ovulation and in vitro fertilization (IVF), where sperm and eggs are collected for fertilization in the laboratory before an embryo is transferred directly into the womb.

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‘The use of endometrial scratching type of In vitro fertilization (IVF) treatment process has reduced over time, probably following studies that do not report that the procedure improves the chance of having a baby.’

Endometrial scratching is a technique in which a small scratch or tissue biopsy is made in the lining of the uterus before IVF.

It has been suggested that injury to the lining of the uterus may somehow increase the chance of an embryo implanting, and therefore pregnancy. Issues include pain or discomfort and additional costs.

Initial studies suggested a potential benefit from endometrial scratching in IVF, especially in women with previous implantation failure. However, many of these studies were deemed to be of poor quality and had a high risk of bias in their design.

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To find the real scenario, a new study anonymously surveyed 121 fertility specialists, embryologists, and fertility nurses, between October and December 2020. The study findings are published in the peer-reviewed journal Human Fertility.

Participants, from Australia (67%), the UK (25%), and New Zealand (8%), were asked about their views on the benefits of the procedure; their clinic’s policies or stance; as well as their thoughts on the advantages and disadvantages.

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The survey results found that over a half (55%) of respondents suggest that endometrial scratching is only offered to patients for psychological reasons, rather than a treatment option for those who have failed with several rounds of IVF.

Only 10% of whom believe endometrial scratching improve pregnancy and live birth rates during the first round of IVF.

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Results also show that an apparent reduction of the treatment over five years, but 34% of clinics still offer or recommend the procedure usually associated with recurrent implantation failures.

What also emerged from the survey is that almost all respondents agreed that pain or discomfort is a major disadvantage, while more than half viewed the cost, inconvenience, and adverse effects as further issues.

Researchers also noted that several limitations of the study, including the low response rate and that respondent with strong views about endometrial scratching (for and against) are more likely to complete the survey, which could limit the generalisability of the findings to all fertility care providers.

The survey was also restricted to three countries, so the findings might not be generalizable to other populations.

Source-Medindia