Sunday 25 February 2018

Simple, inexpensive womb scratch can double chance of giving birth, says new study

Novel treatment gives new hope for infertile women. Stock image
Novel treatment gives new hope for infertile women. Stock image

Laura Donnelly

A cheap technique that involves scratching the lining of the womb could double fertility rates in women, research suggests.

A global study found that women who underwent the procedure during natural or assisted conception had birth rates 2.2 times higher than those who did not.

There has long been debate among fertility experts about the merits of performing an 'endometrial scratch', in which a tiny tube, smaller than a drinking straw, is used to disturb the womb lining.

The review, by Cochrane, an international group of medical researchers, examined eight trials involving more than 1,000 women and found that the procedure appeared to significantly boost birth rates among both women trying to conceive naturally and those undergoing treatment.

British fertility experts said the findings, presented at the European Society of Human Reproduction and Embryology's annual meeting in Helsinki, harked back to theories from the past.

Until a few decades ago, women were routinely given a similar procedure known as a 'D&C' (dilation and curettage) after miscarriage, in the hope it could help secure a subsequent pregnancy, but the practice was largely abandoned for lack of proof that it worked.

Many doctors advocate the €350 'endometrial scratch' but there is little evidence about why it should work. One theory is that it helps the womb lining to shed dead cells, encouraging new ones to grow. Another is that the inflammation caused by the disruption makes the lining more receptive to embryo implantation.

Sarah Lensen, from the University of Auckland, New Zealand, who led the review, said it suggested the practice could increase the chance of live birth from 9pc to between 14pc and 28pc in the period examined.

Adam Balen, chairman of the British Fertility Society, said the practice was increasingly popular, despite uncertainty about whether or not it works.

"It is a tube a little bit narrower than a drinking straw that goes up through the cervix," he said. "It can irritate and cause a cramping sensation, but it doesn't require an anaesthetic."

Large-scale randomised controlled trials are under way in Britain but researchers expressed caution about changing clinical practice, warning of some concerns about the studies.

Nick Macklon, professor of obstetrics and gynaecology, University of Copenhagen and University of Southampton, said he would not recommend it for women attempting natural conception.

"While there might be a place for it in the context of IVF treatment - and we await the results from ongoing randomised controlled studies, which should answer that - we certainty can't draw a conclusion further than that," he said. (© Daily Telegraph, London)

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