At Oxford Fertility we offer embryo transfer 6 days a week. Embryos are usually transferred anytime between day 2 and day 5. Blastocyst transfer is a selection tool which helps us to identify the strongest embryo/s for transfer and is a good technique to use where more good quality embryos have developed by day 3 than are needed for transfer.
Hyaluranon is a naturally occurring substance present in follicles, tubes and cavity of the womb. Its effect is to make the fluid in these areas more viscous (sticky) and to encourage implantation of embryos.
We offer a procedure called an ‘Endometrial Scratch’. Recent studies have suggested that the endometrial scratch may improve implantation rates in patients who have had multiple failed IVF cycles despite good quality embryos. Embryo implantation into the womb may fail due to poor embryo quality or abnormal embryo genetics. It can also often fail due to poor ‘endometrial receptivity’. This is where the lining of the womb is not favourable for the embryo to implant.
The endometrial scratch is a straightforward out-patient procedure which is relatively painless (similar to a cervical smear test). The procedure involves “scratching” the endometrial lining of the womb with a very small catheter (plastic tube) prior to an attempt to get pregnant.
The procedure is thought to increase the immune system cells and therefore the growth factors at the site of the endometrial scratch. This is believed to make the womb lining more receptive to embryo implantation. Studies have suggested that implantation rates may be twice as high in patients who have an endometrial scratch before attempting to get pregnant.
It is recommended that the endometrial scratch is performed in the cycle before you start stimulation medication. Ideally the procedure should be done between days 19 and 25 of your menstrual cycle.
The scratch can be performed in the same cycle as one in which you are trying to conceive naturally.
The risk of a miscarriage if you get pregnant after the procedure is no more than 1%. Given the increased chance of getting pregnant, the benefits of the procedure outweigh any risks.
You will attend the clinic with a semi-full bladder (drink 300ml of water 1 hour prior to the procedure, and do not empty your bladder during this time). First the Doctor will perform an internal ultrasound scan to assess the shape and position of the womb. A very small catheter will then be inserted through the cervix into the womb. This catheter will be used to scratch 4 areas on the womb lining. You may experience slight discomfort as the catheter is being passed into the womb.
After the procedure, a small amount of vaginal spotting or bleeding is not unusual. You can commence an IVF cycle as normal the following month or try a natural cycle in the same month.