COVID-19 Announcement from the Practice

The Center for Fertility and Gynecology

Does endometiral “scratching” help with pregnancy?

By on November 22, 2013

At our fertility center, the Center for Fertility and Gynecology in Los Angeles, we stay abreast of the latest breakthroughs and discoveries in the field of fertility.  From high-tech innovations like array CGH for PGD, sperm DNA analysis (SCSA) or novel IVF stimulation protocols, we are proud to stand on the cutting edge of reproductive science.

One recent development we are embracing is the utilization of endometrial “scratching” or “damage” to improve pregnancy rates. The idea is that a small amount of endometrial damage results in a minor inflammatory reaction which makes the endometrium more receptive to an embryo.  This theory originated from the observation that many women become pregnant following an intrauterine procedure such as a D and C.  Doctors have long wondered if the procedure somehow made it easier for an embryo to implant.


The idea is further bolstered by the fact that placentas often attach to the uterus in locations of prior damage, such as c-section scars.  Placenta accretea, is an extreme example of this phenomenon, but helps to illustrate the point that placental attachment is not hindered by endometrial disruption. 


Within 3 months of the expected embryo transfer, the patient comes into the office for a pipel procedure.  The procedure consists of passing a thin, flexible tube through the cervix and into the uterus.  A small plastic shaft within the tube is then pulled back, creating a suction force within the tube.  This suction removes any emdometrial tissue it comes into contact with.  By rotating the tube, a significant proportion of the uterine lining can be reached.  The procedure ususally takes about 30 seconds to complete.


Ideal candidates for this procedure are patients who have failed IVF for unexplained reasons.  Also patients who have had very thick linings or irregular endometrial lining could potentially benefit from a pipel procedure.


The pipel procedure is safe and quick.  It can be associated with significant cramping or pain which will generally subside shortly after the procedure. There is also a risk of damage or perfertation of the uterus, although this is a rare side effect. 


Studies which have examined the pipel for fertility have found a range of results.  Some experiments demonstrated no benefit at all, while others showed almost a doubling of pregnancy rates.  We believe that there is promising support to consider this procedure because it is based on sound observational data.  However, like any medical procedure, it should only be used in appropriate candidates.

If you have any questions about endometrial scratching or fertility treatment in general, don’t hesitate to contact us.  We’d be happy to chat with you.

Related to This

Get In Touch

Rate, Review & Explore

Social Accounts Sprite

Bakersfield Office

9610 Stockdale Hwy
Bakersfield, CA 93311

Closed Today

More Info Directions (661) 326-1075

Thousand Oaks Office

415 Rolling Oaks Dr
Thousand Oaks, CA 91361

Closed Today

More Info Directions (805) 807-1075

Torrance Office

24241 Hawthorne Blvd
Ste 201
Torrance, CA 90505

Open Today

More Info Directions (818) 881-9800

Our Lab

5353 Balboa Blvd
Ste 301
Encino, CA 91316

Closed Today

More Info Directions (818) 881-9800

Tarzana Office

18370 Burbank Blvd
Ste 301
Tarzana, CA 91356

Open Today

More Info Directions (818) 881-9800