Fertility Decoded

Endometrial scratch

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

Written by Fertility Decoded. Reviewed by D R, MS (OBG), FRM. Review date: 31 August 2026.

The verdict

Evidence doesn't support routine use.

Who are these bodies?

HFEA
— UK fertility regulator; rates add-ons by evidence (traffic-light).
ESHRE
— European fertility society; evidence-based practice guidance.
NICE
— UK health-guidance body; what the NHS will and won't fund.
ISAR
— Indian Society for Assisted Reproduction; Indian expert consensus.
Cochrane
— Independent global reviewers of the underlying studies.

  • HFEA

    UK regulator

    Yellow — unclear/conflicting — chance of a baby
    Source

  • ESHRE

    European society

    Not recommended

    Not recommended — no increase in pregnancy or live birth.

    Source

  • NICE

    UK NHS guidance

    Do not offer (2026)

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

    Source

  • ISAR

    Indian society

    No 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).

Typical cost in India

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

Sources

Take this further

Sources last reviewed .