What Is Uterine Curettage and When Is It Performed?

Assisted reproductive procedures could be frustrating for couples. Sometimes, even with healthy embryos, embryo implantation failures occur. In these cases, uterine curettage could also be useful.

Uterine curettage, also often called dilation curettage, is a minimally invasive procedure that causes a change within the inner layer of the uterus (endometrium) to hurry up its recovery to increase its receptivity in the course of the embryo implantation process.

It is considered one of the procedures utilized in assisted reproduction for ladies who don’t grow to be pregnant as a result of repeated failures during implantation. Despite this, it will not be freed from negative effects and its advantages are still being discussed. Let’s see intimately what it consists of.

When is endometrial curettage really useful?

Currently, endometrial curettage is really useful for ladies who’ve undergone the procedure not less than two cycles in vitro fertilization and suffered repeated implantation failures. This implies that despite the great quality of the embryos, the embryo transfer process failed.

It is feasible that the issue has to do with the communication between the embryo and the uterus, as no egg or sperm abnormalities were detected.

Uterine curettage procedure

During curettage of the uterus, a small amount of injury or “scraping” occurs to the liner of the within the uterus, the endometrium. This is where the embryo implants. The procedure is secure, easy and doesn’t take greater than half an hour.

It is frequently performed as a part of a gynecological consultation via an endometrial biopsy or hysteroscopy, when more detailed imaging of the uterine structure is obligatory to rule out possible causes of embryo implantation failure.

During this process, a 3 millimeter thick flexible catheter is inserted through the opening within the cervix to scrape off the endometrium. This is comparable to the one used for embryo implantation.

With hysteroscopy, the within the uterus could be visualized. In this case, an endoscope is introduced, which allows not only to scrape the partitions, but additionally to search for polyps, adhesions or anatomical defects with its camera.

When should or not it’s scheduled?

It is really useful to perform curettage of the uterus within the mid-luteal phase of the cycle preceding embryo transfer. That is, across the twenty first day of the menstrual cycle in a traditional woman, or one week before the likely date of menstruation of the cycle wherein the embryo transfer is planned.

Embryo transfer can involve embryos fertilized with an egg and sperm from a pair or through embryo donation.

What needs to be considered at the tip of the procedure?

After the intervention is accomplished, it is strongly recommended avoid intercourse on the identical night. In addition, you need to avoid using tampons or menstrual cups during post-procedure bleeding.

How does uterine curettage work?

The mechanism by which uterine curettage increases the probabilities of embryo implantation remains to be unclear. However, it has been suggested that inducing endometrial trauma triggers an inflammatory response that supports tissue regenerationwhich improves the connection of the endometrium with the embryo.

This response triggers the discharge of growth aspects, various chemicals, and certain hormones that promote epithelial repair. In addition, it’s believed that it could actually activate the genes answerable for implantation.

Negative effects of the intervention

Endometrial curettage, as a minimally invasive technique, is taken into account secure. Overall, it has only a few negative effects. Light bleeding after the procedure is common, in addition to abdominal cramps similar to people who occur during menstruation.

On the opposite hand, in very rare cases, infection of the pelvic area or accidental perforation of the uterus may occur. The most vital thing is to rule out pregnancy by in search of the gestational sac using transvaginal ultrasound, as curettage of the uterus within the event of pregnancy would end in miscarriage.

Intervention controversy

in 2021 review of many studies was published on Cochrane Library website where the authors concluded that there’s insufficient evidence to support the usage of uterine curettage as a technique of accelerating the clinical pregnancy rate.

This is why, it will not be really useful to routinely offer it to women who will pass in vitro fertilization procedure.

For years, it has been suggested that it might increase embryo implantation. However, its effectiveness has only been determined in the proportion of girls with prior implantation failure.

However, as a minimally invasive, secure and cheap procedure, it’s still an option especially in couples in developing countries or later two or more failed in vitro fertilization trying.

More research into its effects is required to find out its true advantages.

What to recollect?

Currently, the chances of assisted reproduction are diverse and could be adapted to individual needs. Therefore, before you select to curettage of the uterus, it’s idea to explore its pros and cons. Ideally, all questions needs to be answered by an authority gynecologist.

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