I was on Sky News with Allan Pacey of the British Fertility Society this morning discussing endometrial scratching. It’s a technique that has been used in some UK fertility clinics for a while now, and involves scratching the lining of the womb before embryos are put back during an IVF or ICSI cycle. At the moment, it is most often used when women have good quality embryos but treatment hasn’t worked, and it seems to improve implantation,
Today’s story was based on a paper being delivered at a conference called the World Conference on Ultrasound in Obstetrics and Gynaecology by researchers from Nottingham and Brazil which found a large increase in IVF and ICSI success using the technique. It is a promising study, but what we don’t yet know is whether this could be replicated on a larger scale with a wider group of patients. The average age of the patients in the study appears to be 32, which is an age at which IVF/ICSI is more likely to be successful – and at which egg quality is likely to be better.
Of course, any steps to further increase IVF success should be welcomed, but being invited to discuss the study on Sky News today, all I could think about was how difficult it is to be a patient facing endless headlines about new research or new techniques which are about to revolutionise the world of assisted conception. As I’ve said here before, there’s often a big gap between research and reality. In this case, that’s not quite the case as endometrial scratching is already being offered in the UK – but it’s how and when it is offered that is so crucial.
I did a completely unscientific trawl of clinic websites this morning, and discovered that most were offering it when treatment had been unsuccessful – but the price ranges were fascinating. We’re being told that this is an inexpensive procedure and one clinic was performing it at no extra charge at all (during an IVF/ICSI/FET cycle where the embryos were good quality but two previous cycles had been unsuccessful), most were charging around the £100 rate and I found one billing patients just shy of £400.
It’s embryo quality which is the other sticking point here. It seems that this technique has a lot to recommend it where there are good embryos, but in women whose fertility is affected by their egg quality (which is predominantly older women) this process may not make the same sort of difference.
So, in conclusion – yes, do ask your consultant about endometrial scratching but do be guided by his or her views on this. It’s a technique which may help many women, but which may have less to offer to others. And, as always, more research is needed…