New study confirms that Pipelle really does work

A report in Sky News on 6th October 2013 described the findings of a scientific group investigating a ‘new’ technique to improve IVF success rates. Herts & Essex Fertility Centre introduced this technique for all our patients in 2011.

Scientists in Nottingham and Brazil claim the technique called “endometrial scratching” has improved the live birth rate by around 20%.

It involves medically administering damage to the inner lining of the womb. While it is not a new procedure, the study looks into the optimal timing for giving the procedure to a patient, shortly before fertility treatment.

Study co-author Dr Nick Raine-Fenning, from Nottingham University Research and Treatment Unit, said: “This is the first well-designed trial conducted into endometrial scratching and the results are promising.

“Other trials have provided anecdotal evidence, but these have been limited and many questioned the validity of the technique. We are now carrying out a follow-up study in Nottingham to provide further guidance.”

Early indications show that the Nottingham trial looks set to be even more successful that the Brazil study.

The “scratching” is given just once to women, between seven and 14 days prior to undergoing fertility treatment.

Brazilian researchers recruited 158 women, all of whom had previously undergone unsuccessful fertility procedures, and who were taking an oral contraceptive pill before the treatment began.

Some 77 of these women were picked at random and received the “scratching” procedure. Some 39 of the 77 became pregnant, and 33 cases resulted in live births.

Researchers in Brazil said the study showed that the number of live births increased from the current average of 23% to 42%.

Dr Nick Raine-Fenning said they were not sure why the procedure was working but one theory was that it was “awakening” the womb by encouraging regeneration.

“We  think with the biopsy (scratch) as simple as it is might wake the lining of the womb up by causing a little bit of damage so the womb has to regenerate itself and fix itself, hopefully in a better way.”

Herts & Essex Fertility was one of the first fertility clinics in the UK to introduce the procedure. We perform it prior to all fresh as well as frozen IVF cycles and have certainly seen a significant improvement in success rates.

Pregnancy rate after endometrial injury in couples with unexplained infertility: A randomized clinical trial

Does adding endometrial scratching to diagnostic hysteroscopy improve pregnancy rates in women with recurrent in-vitro fertilization failure

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