When is endometrial scratch recommended for implantation failure?

An endometrial scratch involves passing a thin instrument through the cervix to gently disturb a small area of the womb lining. It is usually planned before a future embryo-transfer cycle. The proposed effect is related to how the lining heals, but the procedure does not correct every cause of implantation failure and evidence of benefit is not consistent for all patients. It can cause cramping and light bleeding.

Ask the fertility team to review embryo development, the womb cavity, hormone preparation, transfer technique and any medical conditions before choosing this option. Discuss the expected discomfort, pain relief, infection precautions, timing and alternatives. Confirm whether the procedure would change your treatment plan or simply add another intervention.

After the procedure, contact the clinic for fever, worsening pelvic pain, offensive discharge or bleeding that becomes heavy. Seek urgent care if you feel faint, develop severe pain or cannot keep fluids down. Tell the team about medicines, allergies and any possibility of pregnancy before scheduling the procedure.

Ask why scratch is being considered now, what other explanations have been checked, how it could affect the next cycle, what risks matter for you, and what you will do if you decide not to have it.