Tanya Smith Acupuncturist Chinese Medicine Practitioner

Endometrial scratch and acupuncture

A client called the other day to tell me that she is going in for an endometrial scratch procedure this cycle to prepare for a frozen embryo transfer next month. She said her fertility doctor described it as “cultivating the soil”.

One of the ways I describe my work is that we cultivate the soil before planting the seed, so I wanted to dig a little deeper into endometrial scratching and how it helps support implantation.

Endometrial scratches are done in cases where repeated embryos have been transferred and not resulted in pregnancy. This is the case for my client and her husband. They had a successful IVF cycle and came out with 6 healthy, genetically normal embryos. They had done two transfers, one with one embryo and one with two. Still no pregnancy.

While IVF technology continues to improve to make healthy embryos, implantation in the uterus is still relatively “up to the gods”.

The uterine lining is some of the most metabolically active tissue in the body. It is constantly responding to both physical and hormonal influences. If the tissue is underactive or not performing all of the changes needed , it will reduce receptivity to an embryo. According to one researcher, “A major reason for implantation failure of the in vitro grown embryo is still an inadequate uterine function.” (1)

The endometrial scratch procedure activates an inflammatory response which seems to “wake up” the function of the uterine tissue and improve it’s receptivity in the following cycle.

I imagine this like a garden where the soil is turned over in the spring to “wake it up” and get it ready to plant the seeds. And while the turning over of the garden is an important part of the process, the health of the soil is still what will support the growth of the seed. If the uterus tissue is underactive, it is likely not getting the blood flow and nutrients that it needs for healthy function. And that’s where I think acupuncture plays a huge role in helping to “cultivate the soil”.

Acupuncture improves blood flow to the uterine lining. Full stop. It is the only therapy that has a sustained effect on blood flow to the uterus. That means that even weeks after your acupuncture sessions, your uterus is still receiving improved blood flow. Acupuncture improves outcomes when it is used in preparation for an IVF cycle. (2)

Adding acupuncture treatments to your care in the lead-up to your transfer makes a lot of sense. There are also a number of things you can do in your daily life to improve your uterine lining. Read this article with my best DIY tips for improving your uterine lining.



  1. Gnainsky, N et al, Biopsy-induced inflammatory conditions improve endometrial receptivity: the mechanism of action, Reproduction January 1, 2015 149 75-8
  2. Hullender-Rubin, L et al, Impact of whole systems traditional Chinese medicine on in vitro fertilization outcomes. Reproductive biomedicine online 30(6) · February 2015

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