Additional techniques and treatments (Add Ons) are optional extras that are available to you in addition to your normal fertility treatment. These have extra costs associated with them. Oxford Fertility aims to provide the best evidence based additional techniques but they are not suitable for all patient groups. Please ask to discuss this with your consultant if you wish to take up any of these treatments.
An independent traffic light system review of all available Add Ons is available on the HFEA website. https://www.hfea.gov.uk/treatments/explore-all-treatments/treatment-add-ons
At Oxford Fertility we offer embryo transfers 7 Days a week. Embryos are usually transferred on day 3 (cleavage stage) or day 5 (blastocyst stage). The advantage of culturing to blastocysts stage is that it allows the embryologist to gather extra information regarding the potential of the embryos so that the strongest embryo can be selected for transfer in order to give you the best chance to conceive.
EmbryoGlue is a different type of culture media used in the laboratory at the time of the embryo transfer. This media has an increased viscosity compared to conventional embryo transfer media and contains a product called hyaluronan. Hyaluronan is a compound found throughout the body, with increasing concentrations found in the uterus at the time of implantation. The embryo(s) are placed in the EmbryoGlue for at least 10 minutes prior to the embryo transfer as this allows them to soak in the media. 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.