Hysteroscopy and Biopsy (Womb Scratching) Aiding in IVF Success – The 411

baby - hysteroscopy

The procedure, known as womb scratching, or endometrial biopsy, feels much like a pap smear and costs approximately $200, hardly breaking the bank compared to other treatment-associated costs. When timed one month before an IVF cycle, a woman who receives womb scratching is twice as likely to become pregnant as a woman who does not undergo the 15-minute procedure.

baby - hysteroscopy 2

How is womb scratching done?

Laurence Jacobs, M.D. of the Fertility Centers of Illinois says the biopsy uses a Pipelle to lightly scratch the endometrial lining. “Local injury of the endometrium produces an inflammatory reaction resulting in increased white blood cells (leukocytes such as macrophages) which secrete growth factors and cytokines. These substances regulate blastocyst implantation and placental development”, he states. This stimulates the uterus’ receptivity to the embryo and increases the success rate of live birth. The most acceptable use of womb scratching is in women with good egg quality, but failed IVF cycles.

The procedure can be performed in-office by an OB/GYN trained in the “four quadrant uterine biopsy”, a method of cell collection similar to a pap-smear or cell collection for cancer screening. However, it is most efficient to combine womb scratching within a fertility treatment protocol or an already scheduled hysteroscopy if fibroids or polyps are suspected.

Dr. Jacobs claims the procedure carries little risk to the patient for pain or infection. In fact, doctors are so confident in the success that many, like Jacobs, offer it routinely to IVF patients who have failed previous cycles despite good embryo quality. Jacobs says, “At the present time, the endometrial biopsy should probably be reserved for those patients failing IVF despite good or excellent embryo quality, where uterine receptivity appears to be the major underlying problem.” Endometrial biopsy may not be the best option for patients of advanced maternal age with a history of failed IVF cycles due to genetically abnormal or poor quality embryos. In that case, genetic testing may be employed to verify the quality of the embryo and genetic soundness prior to embryo scratch.

How effective is womb scratching?

Several recent studies, including a British study published in Reproductive BioMedicine Online, confirm that womb scratching can double the success rate of pregnancy and live birth when performed at the right time.

“Timing is everything”, says Jacobs, “It’s very important to do an endometrial biopsy at the right time. In one study where the biopsy was performed at egg-retrieval, the women who had the procedure experienced lower pregnancy rates than controls.” It is currently believed that the best time to perform the scratch is once or twice in the month preceding an embryo transfer. It should not be done in the same cycle as ovarian stimulation for fresh IVF, or estradiol for a frozen embryo transfer (FET).

Consult your doctor to determine if womb scratching is an option for you.

Source:  http://www.fertilityauthority.com

Additional Resources:

http://www.dailymail.co.uk/health/article-2808964/How-scratching-lining-womb-double-chances-having-IVF-baby.html

http://abcnews.go.com/Health/WomensHealth/womb-scratching-technique-boost-ivf-success/story?id=17365332

http://www.thetimes.co.uk/tto/health/news/article4248667.ece

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IVF #4 Upcoming – The 411

baby - ivf egg and sperm

Last night, Dr. Robert Kiltz, who owns CNY Fertility Center and Spa, called me and said he wanted to schedule a phone consult with me for Saturday morning.  He said he was reviewing my file and would call me.  This morning, as promised, he called to discuss my latest failed cycle and to make a plan to move forward.

He wants me to try one more cycle with my own eggs prior to moving on to donor eggs.  He feels that I have good equality and is happy that he sees all my embryos making to blast.  He feels that I need to do a few things:

–  Add Saizen / human growth hormone to my cycle to improve maturation and egg quality

– Use neupogen post transfer

– Do a neupogen wash

–  Do a Hysteroscopy with biopsy

– Do an endometrial scratch on day two of my cycle to improve implantation

– Continue on an estrogen priming protocol

– Use 300 Gonal-F and 300 Menopur with Lupron for stims again

I have decided to give my own eggs one more last shot while I am saving up for a donor egg cycle.  I am going to detox my body first.  All of these hormones have take a toll on my body.   I am going to start a protein train on Monday (protein shakes only, apple sauce, sf popsicles, sf jello, water, diluted apple juice, oatmeal).  I will actually start by drinking only water with lemon, cayenne pepper and grade A maple syrup for two days to detox my body from my sugar habit.  It really does work !  By drinking loads of the lemon cayenne tea, it cuts sugar cravings and helps you follow the Bariatric diet more easily.

For those that did not know, I had gastric bypass surgery March 31, 2004.  When I follow a strict diet for short periods, it helps me refocus and I also drop weight pretty quickly.  I want to get back to my starting weight prior to starting stims.  I should be able to drop the few pounds I have gained due to the hormones.  It can only help with my quest to get pregnant.  Weight loss releases the hormones that are stored in body fat back into the bloodstream.  This is why a lot of women who became infertile due to obesity find themselves pregnant unexpectedly after gastric bypass, lapband, or significant weight loss.

Ironically, one of my friends out of the blue reached out to me late yesterday and said that God had laid on their spirit to relay to me to hold on…. that my bundles of joy were on the way.  I told my friend to go back and relay a message for me…  I will hold on, but can He speed up this timeline ! lol