The SiM trial: can scratching the lining of the womb encourage healthy pregnancy?

Siobhan Quenby, Varlar Kandaval, Shreeya Tewary, Mariam Lokman

We are trying to find out if a simple procedure before conception could help prevent miscarriage. If so, this could be an easy way to encourage healthy pregnancy.

Evidence suggests that problems with the lining of the womb – the endometrium – are related to having multiple miscarriages.

Even though it seems strange, we think that scratching the lining of the womb on purpose before pregnancy could help stop this from happening. The SiM (Scratch in Miscarriage) trial is testing whether this could work, and if women would be happy to try it. Even in its early stages, it has captured the public imagination, and up to 83% of women approached to take part chose to become involved.

We are pleased to say we have now completed recruitment to the study, with 150 women participating. 

Women taking part are under 40, and have suffered from two or more miscarriages in a row. Each woman has been randomly put into one of two groups, but doesn’t know which. One group of women has had their endometriums scratched before pregnancy, between ovulation and getting their period. The other group has simply had an examination of their cervix, but will not have been able to tell whether or not they have been scratched.  

For women in the scratching group, doctors have inserted a long, thin device into the vagina and through the cervix. While pressing against the lining of the womb, they move the device up and down for around 15 seconds, which is enough to create a small scratch. They have also taken a sample of endometrium for further study.

After they conceive, we will then follow each woman throughout pregnancy. This will let us see if women who had their endometriums scratched before pregnancy are more likely to have healthy pregnancies, and less likely to miscarry.  By studying the endometrial samples, scientists will also be able to look for new ways of testing for endometrial problems in women with multiple miscarriages. We hope this will lay the foundation for a much bigger clinical trial in the future. 

The SiM trial is recruiting - find out about taking part

Thanks for your interest in our research

Tommy's funds research across the UK investigating the reasons for pregnancy complications and loss. Maternal and fetal research is underfunded and we need your support to continue. There are many small and large ways you can support us, find out more here.

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