First period after endometrial scratch

The first period after an endometrial scratch may be different in timing, flow, or cramping, while mild spotting can occur soon after the procedure. A scratch is a brief procedure involving the uterine lining, so procedure-related spotting and menstrual bleeding should be considered separately.

Spotting shortly after the procedure may come from irritation of the cervix or uterine lining. The next true period depends more on ovulation and the fertility medicines or cycle schedule around the scratch. Some people have stronger cramps or a flow that differs from usual; this does not by itself show whether implantation or treatment will occur.

Bleeding with fever, unpleasant-smelling discharge, escalating pelvic pain, or feeling unwell is not something to monitor alone. These symptoms can signal infection or another problem and warrant contact with the fertility team.

Note the procedure date, spotting, period start, pain, and any medicines used. Follow the clinic’s instructions about intercourse, exercise, tampons, and the next fertility step. Use the recommended pain relief and avoid adding medicines that could conflict with your treatment plan. A home pregnancy test may be misleading if fertility medicines containing pregnancy hormone were used, so ask when testing is meaningful.

Contact your clinic promptly for increasing pain, heavy bleeding, fever, chills, dizziness, or discharge with an unusual smell. Seek urgent help if you feel faint, develop severe pain, or bleed heavily and rapidly. If your period is late, ask whether to test for pregnancy and whether the planned treatment cycle should continue or be rescheduled.

Ask what spotting pattern is expected after your procedure, when your clinic considers bleeding a period, and which symptoms suggest infection. Discuss the timing of pregnancy testing, medicines for cramps, and how the scratch fits into your next transfer or ovulation plan.