d&c

Scratching your way to pregnancy- Endometrial biopsy before IVF

endometrial-biopsy-princeton-ivfIn recent years, endometrial scratching, irritating the endometrium (lining of the uterus) to help in making the womb more receptive for pregnancy has emerged as a new and unsual way to help couples get pregnant.  Recently, a group from Turkey presented data at the American Society of Reproductive Medicine meeting suggesting that performing an endometrial biopsy prior to IVF can improve pregnancy rates in women undergoing IVF by about 20%. In fact over the years, seeming against common sense, there have been a number of studies suggesting  that a biopsy and/or hysteroscopy may improve the chances for IVF success. At Princeton IVF, we have been using this technique for years, first in patients who failed cycles without any good explanation and then routinely in all our IVF patients. Although no one is quite sure why it helps, it is likely that the repair process from endometrial trauma helps to make the uterus more receptive to embryos.

Aspirin and miscarriages

aspirin-baby-81It is quite common for both OBGYN and Fertility doctors to encourage their patients who have had multiple miscarriages take baby aspirin in order to reduce the risk of future pregnancy losses. The problem with this is that these recommendations were never really backed up by research to see if aspirin is really effective in preventing miscarriages. In order to determine if this common practice was effective, the NIH conducted a large trial to see if taking daily baby aspirin would reduce the risk of subsequent miscarriage in women with 1 or 2 prior miscarriages. Unfortunately, as reported in the journal Lancet,  baby aspirin did not help and these women were no more likely to experience another pregnancy loss than those who took a placebo. The one bright spot in this study: women who took had a single loss early in pregnancy within the last year and took baby aspirin were more likely to actually become pregnant.