Intrauterine wash/infusion before embryo transfer

A growing number of studies have continued to validate our pioneering work on intentional injury to the uterine lining (creation of implantation points/cuts/pipelle scratches) as being beneficial for the implantation rate for women who have been suffering from repeat failed IVF (failed implantation). For many of our patients, we find hysteroscopy with implantation cuts to be very beneficial in improving the chance of implantation, but as we expected, making a signficant injury like a pipelle scratch to the uterine lining very close to embryo transfer is unlikely to improve the pregnancy rate as it disturbs the uterine lining too much.  Its beneficial to have an alternative option we can use very close to the embryo transfer.

Other studies have already suggested a benefit from a gentle intervention shortly before embryo transfer just 4-5 days before.   A 2011 Egyptian study showed a significant increase in the pregnancy rate using a saline infusion to the uterus with added HCG just before embryo transfer.   Our own experience at Serum also showed an improvement in the pregnancy rate by doing this, but we have found it is equally effective to do the infusion with or without HCG suggesting that the benefit is due to the effect of this gentle injury/inflammation of the lining rather than the HCG itself.

This technique is particularly useful because it gives a statistical increase in the pregnancy rate but can be done on the same visit as the embryo transfer.

Intrauterine wash/infusion before embryo transfer

A growing number of studies have continued to validate our pioneering work on intentional injury to the uterine lining (creation of implantation points/cuts/pipelle scratches) as being beneficial for the implantation rate for women who have been suffering from repeat failed IVF (failed implantation). For many of our patients, we find hysteroscopy with implantation cuts to be very beneficial in improving the chance of implantation, but as we expected, making a signficant injury like a pipelle scratch to the uterine lining very close to embryo transfer is unlikely to improve the pregnancy rate as it disturbs the uterine lining too much.  Its beneficial to have an alternative option we can use very close to the embryo transfer.

Other studies have already suggested a benefit from a gentle intervention shortly before embryo transfer (e.g. 0-36 hours before).   A 2011 Egyptian study showed a significant increase in the pregnancy rate using a saline infusion to the uterus with added HCG just before embryo transfer.   Our own experience at Serum also showed an improvement in the pregnancy rate by doing this, but we have found it is equally effective to do the infusion with or without HCG suggesting that the benefit is due to the effect of this gentle injury/inflammation of the lining rather than the HCG itself.

This technique is particularly useful because it gives a statistical increase in the pregnancy rate but can be done on the same visit as the embryo transfer and we have the option to slightly vary the magnitude of the injury/inflammation effect according to how much time we have available before embryo transfer so that we can aim for the most gentle infusion just before embryo transfer or a more robust wash/aspiration 1-3 days before embryo transfer.