What is a womb scratch?
Could there be a more terrifying sounding term than “womb scratch”? It is the process whereby doctors make a tiny scratch to the endometrial lining to stimulate fresher, healthier cell production and increased white blood cells to the area. It is generally used for women who have experienced endometriosis, or suspected endometriosis, or are on the older side of the fertility rainbow. Studies have shown that it increases chances of implantation and live birth by 50%! That is a significant increase in anyone’s estimation. So when the nurse casually informed us that I had been put forward for an endometrial scratch, as I had suspected past endometriosis and am on the older side, I said yes I will do it without hesitation. Then I got home and panicked.
There are two worrying aspects to the womb scratch process. Firstly, you have to have protected sex for the cycle of the scratch. Everyone who has been trying to get pregnant knows that missing a cycle feels like missing a huge opportunity. I swung wildly between thinking that this specific cycle could have been the magical one that would have naturally gone right, to being incredibly grateful for the opportunity and science to perform these amazing procedures to help with fertility.. Luckily gratitude won out.
The second worry was that my womb was to be scratched. Anyone I mentioned it to, men or women, involuntarily flinched when those terms were spoken. Years of nurturing my womb and imagining it as a safe space to protect and carry our baby had to be turned on its head. My endometrial tissue would be torn. On purpose. But for a hugely increased chance of success.
What to expect?
We went to the unit together for the procedure. The hospital does not allow men into the specific medical pods. This is not for hygiene or safety reasons. The doctor explained that men were asked to stay in the waiting area as not all but far too many of them had fainted in recent years. The medical staff are not able to attend to the passed out male partner, which causes potential liability as well as stress to all involved. The woman’s medical and emotional safety is their priority. The medical team complete the necessary procedure for the woman and then would have to attend to the passed out male partners. “What about women partners or companions”, I asked. “Oh we let them in”, said the doctor, “women know how to be there for one another in the realest terms”.
The womb scratch was relatively simple and straight forward. It was easier than a pap smear for me and many times easier than the HCG test (blog post on fertility MOT tests to follow). The major discomfort is that you have to go in with a full bladder. They recommend filling your bladder up an hour before the procedure. Having a full bladder plus sitting in a waiting area in a state of nerves does not really add up to great comfort.
But the procedure itself is very, very quick. The doctor inserts the speculum and the usual adjustments occur to ensure the correct angle to the cervix. An aspirator is inserted through the speculum into the womb.The pain of the scratch, which is actually a tiny suction device hoovering up cells, is brief and you definitely feel it – like a bolt of concentrated acid lightning to the centre of your being. Apparently I swore out loud. The pain lasted the same time it took me to utter two swear words. There was some dull aching after, and some light bleeding.
Totally manageable for a couple of hours straight afterwards. I did get quite nauseous and bloated later that evening and went to sleep very early. I think that was because of the 4 giant antibiotics I had to take on an empty stomach. Probiotics are firmly on my list of must haves now. Other than that, the process was quick, simple and completely manageable.
1. Have someone with you for support if possible. Mindless chatter is helpful to distract from the nerves and full bladder while waiting.
2. Definitely take pain medication before hand. I wasn’t advised not to by the clinic, so I didn’t ask, and did it anyway as I was fearful of a repeat HCG experience. I used a muscle relaxant that I take when having really painful period pains, not just a couple of paracetamol, and that helped I think in the insertion of the speculum, adjustments and the cramping.
3. Visualise something that makes you happy. Quite by coincidence the doctor and I spoke about a place that we both had in common throughout the procedure. I visualised the ocean and the forests and it was very calming. Usually I ask a million questions about the procedure. So this discovery was really lovely and a nice change that I’m going to make.
4. Probiotics to counter the nasty side effects of antibiotics. Don’t get me wrong, antibiotics are wonderful, but the nausea, IBS type symptoms they induce in me are awful.
5. Panty liners are useful. You pretty much start spotting immediately afterwards for about a day.