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Mechanical Endometrial Injury (MEI)


What is it?


Mechanical endometrial injury, or MEI, is a simple procedure performed on the endometrial lining by one of the consultants at Fertility North.


An increasing body of evidence is reporting consistent findings of an improved rate of implantation, clinical pregnancy and live birth in relation to IVF treatment cycles that follow a mechanical injury to the endometrium in the cycle
proceeding the treatment cycle.


During a MEI the endometrial lining is gently scratched by a thin catheter called a pipelle. There are a couple of reasons why a scratching may be beneficial including;

  • Scratching away a small portion of the lining causes a repair response by the body, and this repair response releases growth factors, hormones and chemicals. When the lining repairs and regrows, it is thought that the lining is more receptive to implantation.
  • Some scientists that have studied the MEI believe 
    the scratch may also cause a switching on of certain genes that help prepare the endometrium for possible implantation.


For whom is it suitable?


The consultants at Fertility North will recommend MEI for those patients who have repeated early pregnancy losses, those who have been seen to repeatedly not have an embryo implant, or at the doctors’ discretion.


When is it done?


The procedure is done five to seven days pre your treatment cycle. The nurses at Fertility North will advise you.


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Pre-planning


When you book to have a MEI, it will add a month onto your treatment cycle, so please ensure you allow time for this.


You must phone the nurses on day 1 of your cycle to book in for a blood test at the time ovulation should occur for you. This is done to ensure the procedure is booked in at the correct time of your cycle to optimise the impact.


It is very important you DO NOT HAVE UNPROTECTED INTERCOURSE IN THE MONTH YOU HAVE YOUR MEI DONE. We cannot test for pregnancy at the time the MEI is done, so if there is any chance you may be pregnant, the procedure will not be performed and this may delay your treatment.


How is it done? 


The MEI is similar to a pap smear. It is done in the clinic at Fertility North by one of the fertility consultants, not necessarily your consultant. We book our MEI’s for around midday Monday to Friday, and mid-morning on a Saturday.


The time of your procedure will be available the day before your procedure.


  • Before you come in for the procedure, we
    recommended you take some over the counter
    analgesia, such as paracetamol with codeine, half an hour before your procedure time.
  • Have a full bladder
  • Please arrive 15 minutes before your procedure to allow time for you see reception.
  • The nurse will take you down to the procedure room and allow you to get comfortable.
  • The consultant will cover you with a green sheet, insert a speculum to visualise the cervix, clean the cervix with a chlorhexidine solution, then pass the pipelle into the uterine cavity and ‘scratch’ the lining.



What are the risks involved? 


As with any procedure, infection can occur. Please speak to the nurses should you start to experience any of the following symptoms:


  • Unexplained fever
  • Persistent bleeding or an abnormal smelling or coloured vaginal discharge
  • Increasing lower abdominal pain
  • Feeling generally unwell​​​​​​​


Is it painful?


Most women experience some mild lower abdominal
cramping at the time of, and soon after the procedure. This is why we recommend the use of analgesia pre-procedure.


Should the cramping continue when you return home, you can use a heat pack to relieve discomfort.


What does it cost?


For costs associated with this procedure, please speak to reception staff at Fertility North.