Even if in the last decades there were found new techniques in order to increase the results of an in vitro fertilization (IVF/ICSI), like in the egg donation, the rate of pregnancies and newborns nowadays is around a 40 % or 50 %. That means it is still a long way to have a success rate of almost 90 %.
The major progresses in IVF/ICSI and egg donation have been made above all in the ovary stimulation, which are always safer and more effective. Other sectors with progress were made in the embryology, not only in the obtaining of oocytes, but also in the surveillance of the embryonal development, which favors the increase and efficacy of the results.
Nevertheless, little progress was made in the endometrial conception, concerning IVF as well as egg donation. That means that we have not reached the goal to increase the adherence of the embryo to the endometrium.
In order to improve the endometrial conception, there is a technique called Scratching, or endometrial injuring. The base of this technique is initiating small injuries in the endometrium through a biopsy, scraping or hysteroscopy. We recommend undergoing t a scratching treatment before the ovary stimulation when doing an IVF cycle or right at the beginning of the endometrial preparation when doing an embryo transfer. The aim of this technique is increasing the embryonal adherence and by doing so achieving a pregnancy.
Scientists do not know the exact mechanisms taking place during the endometrial adherence, but there are many hints that Scratching increases the decidualization and the secretion of the cytokines, which induces a higher implantation rate. The efficacy is controversially discussed, as there are studies which showed an exit rate of 30 % on the one hand. On the other hand, other publications have shown the treatment´s inefficacy.
Nowadays, considering our knowledge about the intimate mechanisms during the embryonal implantation, this easy and quick technique can show a certain utility, above all when there were previous failed attempts.
CONCLUSIONS
Today the major reason for the failure of assisted reproduction treatments (IVF/ICSI, egg donation) is because we still do not know the details of the mechanism of embryonal adherence.
I this situation of missing knowledge of the endometrial adherence, Scratching can be a useful technique, above all if there were previous failures.
We are waiting for your questions on info@centromedicomanzanera.com or through our contact form which you can find on our website: https://centromedicomanzanera.com/formulario_es/
Gregorio Manzanera
Gynacologist
IMAGE: https://www.verywellfamily.com/implantation-906754
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