I often talk with patients about endometrial scratch biopsy. It's a relatively simple and quick procedure which makes a few scratches inside the uterus, and it turns out that these small injuries can actually increase fertility in many women.
A 2016 study examined how endometrial scratching might improve the success of IUI (with Clomid) in a group of one hundred and fifty four women. Over three cycles, the pregnancy rate in women who received the procedure was 39% compared to just 18.2% in women who did not undergo endometrial scratching. Consequently, the researchers drew the following conclusion.
“The ESI (endometrial scratch injury) significantly improves the outcome of IUI in women with unexplained infertility especially when conducted 1 month prior to IUI."
Most studies to date on this procedure have focused on women undergoing IVF, it's exciting to see how women conceiving with IUI may benefit similarly.
Reference: Reprod Sci. 2016 Feb;23(2):239-43. Endometrial Scratch Injury Induces Higher Pregnancy Rate for Women With Unexplained Infertility Undergoing IUI With Ovarian Stimulation: A Randomized Controlled Trial. Maged AM1, Al-Inany H2, Salama KM3, Souidan II3, Abo Ragab HM3, Elnassery