Fertility Decoded

Endometrial scratch

Deliberately scratching the womb lining before a cycle, in the hope it aids implantation.

The verdict

Evidence doesn't support routine use.

Evidence positions on Endometrial scratch from HFEA, ESHRE, NICE and ISAR
BodyPosition
HFEA
  • Yellow — unclear/conflictingfor chance of a baby
ESHRENot recommended

Not recommended — no increase in pregnancy or live birth.

Source
NICEDo not offer (2026)

NG257 1.40.1: do not offer endometrial scratch as a pre-treatment to improve IVF outcome.

Source
ISARNo position

Not addressed in the 2021 ISAR add-ons consensus.

Cochrane evidence base

2021 review: inconclusive; does not support routine universal use (some newer meta-analyses hint at benefit — evidence remains mixed).

In India

Relatively low cost, ~₹3,000–10,000; often bundled.

Sources

Take this further

Last reviewed .