By Healthtrip Blog Published on - 05 October - 2023

The Role of Endometrial Scratching in IVF Success in Thailand


In recent years, Thailand has emerged as a popular destination for couples seeking in vitro fertilization (IVF) treatment. With its world-class medical facilities, experienced fertility specialists, and competitive pricing, Thailand offers an attractive option for those facing infertility issues. One of the intriguing techniques gaining attention in the realm of IVF is endometrial scratching. This procedure is believed to enhance the chances of implantation and, consequently, IVF success rates. In this blog, we will delve into the role of endometrial scratching in IVF success in Thailand.

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1. Understanding IVF and Endometrial Scratching

In vitro fertilization (IVF) is a widely used assisted reproductive technology that involves the fertilization of an egg outside the body and the subsequent transfer of the embryo into the uterus. The success of IVF largely depends on factors such as embryo quality, uterine receptivity, and the synchronization between the two.

Endometrial scratching, also known as endometrial biopsy or endometrial injury, is a procedure where the uterine lining (endometrium) is gently disturbed or "scratched" prior to embryo transfer. This technique is believed to stimulate a mild inflammatory response, prompting the body to release substances that improve the chances of embryo implantation.

2. The Science Behind Endometrial Scratching

The exact mechanism behind the benefits of endometrial scratching in IVF is still being studied, but several hypotheses have been proposed:

  • Increased Blood Flow: The scratching may promote increased blood flow to the endometrium, improving its receptivity to the embryo.
  • Cytokine Release: The procedure can trigger the release of certain cytokines, growth factors, and immune system proteins that encourage embryo implantation.
  • Cellular Changes: The injury to the endometrial tissue may prompt cellular changes that make the uterine environment more favorable for implantation.

3. Endometrial Scratching in Thailand

Thailand has rapidly gained recognition as a medical tourism hub, particularly in the field of reproductive medicine. Many IVF clinics in Thailand offer endometrial scratching as part of their IVF protocols, and here are some reasons why this procedure is popular in the country:

  • Experienced Specialists: Thailand boasts a pool of highly trained and experienced fertility specialists who are well-versed in the latest IVF techniques, including endometrial scratching.
  • State-of-the-Art Facilities: The country's IVF clinics and hospitals are equipped with cutting-edge technology, ensuring that the procedure is performed with precision and care.
  • Affordable Costs: IVF treatments in Thailand are often more affordable than in many Western countries, making them accessible to a wider range of couples.
  • Holistic Care: Thai fertility clinics often offer holistic care, including emotional support and counseling, which can contribute to the overall success of IVF treatments.

4. The Research on Endometrial Scratching

Numerous studies have explored the efficacy of endometrial scratching in IVF, and while results vary, some research suggests a potential benefit. For example, a 2019 systematic review and meta-analysis published in the journal "Fertility and Sterility" found that endometrial scratching may improve clinical pregnancy rates in women undergoing IVF.

4.1. Clinical Trials and Studies:

  • A 2019 Systematic Review and Meta-Analysis: Published in the journal "Fertility and Sterility," this comprehensive review analyzed multiple clinical trials and studies on endometrial scratching. It found that endometrial scratching was associated with a statistically significant increase in clinical pregnancy rates in women undergoing IVF. However, the magnitude of this effect can vary among studies.
  • A 2020 Study in "Reproductive Biomedicine Online": This study aimed to assess the effects of endometrial scratching on IVF outcomes. It found that endometrial scratching was associated with a significant increase in clinical pregnancy rates and live birth rates. The authors suggested that this procedure might improve endometrial receptivity, leading to higher success rates.
  • A 2017 Study in "Human Reproduction": This randomized controlled trial investigated whether endometrial scratching improved pregnancy rates in women with a history of recurrent implantation failure. The study found a statistically significant increase in clinical pregnancy rates in the endometrial scratching group compared to the control group.
  • A 2018 Study in "Fertility and Sterility: This study focused on women with unexplained infertility undergoing IVF. The results showed that endometrial scratching led to higher implantation and clinical pregnancy rates in this specific subgroup.

4.2. Mechanisms and Theories:

While the research shows promise, the exact mechanisms underlying the beneficial effects of endometrial scratching are not entirely understood. Several theories have been proposed:

  • Inflammatory Response: Endometrial scratching may trigger a controlled inflammatory response in the uterine lining. This response could lead to the release of various cytokines and growth factors that promote embryo implantation.
  • Improved Blood Flow: The procedure might increase blood flow to the endometrium, potentially enhancing its receptivity to embryos.
  • Endometrial Repair: The physical disturbance caused by scratching may induce a repair mechanism in the endometrial tissue. This repair process could create a more favorable environment for embryo attachment and development.

4.3. Patient Selection and Timing:

The success of endometrial scratching may depend on various factors, including the patient's medical history, age, and the timing of the procedure in the IVF cycle. Many studies have focused on specific subgroups, such as women with a history of recurrent implantation failure or unexplained infertility. Additionally, the timing of the procedure is crucial, and it is typically performed in the luteal phase of the menstrual cycle before the embryo transfer.

However, it's important to note that the effectiveness of this procedure can vary from person to person, and more research is needed to determine the precise conditions under which it is most beneficial.

5. Potential Benefits and Considerations

Before choosing endometrial scratching as part of an IVF treatment plan in Thailand or anywhere else, it's important to consider both the potential benefits and some key considerations:

5.1. Potential Benefits:

  • Improved Pregnancy Rates: Some studies suggest that endometrial scratching may lead to higher pregnancy rates following IVF, making it an attractive option for couples seeking to increase their chances of success.
  • Cost-Effective: IVF treatments in Thailand are often more cost-effective than in many Western countries, and endometrial scratching is typically included in the IVF package, making it a budget-friendly option for many.
  • Expertise and Quality Care: Thailand has earned a reputation for providing high-quality medical care, and its fertility specialists are known for their expertise in reproductive medicine.

5.2. Considerations:

  • Individual Response: The effectiveness of endometrial scratching can vary from person to person. While some individuals may benefit significantly, others may not experience the same results.
  • Timing: The timing of the procedure in relation to the IVF cycle is crucial. It should be performed at the optimal point in the menstrual cycle to maximize its potential benefits.
  • Possible Discomfort: Endometrial scratching can be uncomfortable for some individuals. It's essential to discuss any concerns or discomfort with your fertility specialist.
  • Consultation with Specialists: Couples should consult with experienced fertility specialists who can assess their specific situation and provide personalized advice on whether endometrial scratching is appropriate for them.
  • Other Factors: IVF success is influenced by a range of factors, including age, overall health, and the quality of embryos. Endometrial scratching is just one piece of the puzzle and may not guarantee success on its own.

In Conclusion

Endometrial scratching is a technique that holds promise for improving IVF success rates, and Thailand's fertility clinics have embraced this approach as part of their comprehensive IVF treatment offerings. The country's combination of skilled professionals, state-of-the-art facilities, and affordability makes it an attractive destination for couples seeking fertility treatments.

Read More IVF Treatment for LGBTQ+ Individuals and Couples in Thailand (


Endometrial scratching is a procedure where the uterine lining is gently disturbed before an IVF embryo transfer. It is believed to improve the chances of embryo implantation in the uterus.
Endometrial scratching is performed to create a receptive environment in the uterus, potentially increasing the likelihood of successful embryo implantation during IVF.
While discomfort levels may vary, the procedure is typically not highly painful. Many women describe it as feeling similar to menstrual cramps.
Endometrial scratching is usually done during the luteal phase of the menstrual cycle, a few days before the planned embryo transfer.
Potential benefits include increased blood flow to the endometrium, stimulation of an inflammatory response, and improved endometrial receptivity for embryo implantation.
The risks are minimal, but some women may experience mild bleeding, cramping, or discomfort after the procedure. Serious complications are rare.
No, endometrial scratching does not guarantee success. IVF success depends on various factors, and the procedure is just one element in the overall treatment plan.
The suitability of endometrial scratching varies among individuals. It is often recommended for those with a history of recurrent implantation failure or unexplained infertility.
Costs vary depending on the clinic and location. In some cases, it may be included in the overall IVF package. Insurance coverage also varies and should be discussed with the provider.
Thailand has numerous reputable fertility clinics known for their expertise in IVF treatments. Research and choose a clinic with experienced specialists and positive patient reviews.
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