Endometrial scratching: is it all over?

Endometrial scratching or injury is an intentional damage to the endometrium that is carried out with the aim of improving outcomes from fertility treatment or the chance of natural conception. It is an office procedure performed with a Pipelle biopsy catheter or similar. A number of putative mechanisms of action have been suggested including the proposition that endometrial scratching modulates decidualization by inducing a healing response with specific local inflammatory pathway changes, stimulating angiogenesis and stimulating elements of endometrium-embryo ‘crosstalk’ (Siristatidis et al., 2014).